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Related Experiment Videos

"Isolated" Suprascapular Neuropathy: Compression, Traction, or Inflammation?

Malo Le Hanneur1,2, Andres A Maldonado1,3, Benjamin M Howe4

  • 1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.

Neurosurgery
|March 13, 2018
PubMed
Summary

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Many patients diagnosed with isolated suprascapular nerve (SSN) palsy show signs of broader neuromuscular issues. These findings suggest inflammation may be a common cause of "isolated" SSN palsy.

Area of Science:

  • Neurology
  • Musculoskeletal Imaging
  • Electrophysiology

Background:

  • The pathophysiology of suprascapular nerve (SSN) palsy is debated, with hypotheses including compression, traction, and inflammation.
  • Isolated nontraumatic SSN palsy requires further investigation into its underlying causes.

Purpose of the Study:

  • To investigate the pathophysiology of isolated nontraumatic SSN palsy.
  • To critically reinterpret electrodiagnostic (EDX) studies and magnetic resonance (MR) images of patients diagnosed with SSN palsy.

Main Methods:

  • Retrospective review of 59 patients with nontraumatic isolated SSN palsy over 20 years.
  • Analysis of clinical examinations, EDX studies, and shoulder/brachial plexus MR scans.
  • Independent reinterpretation of EDX and MR findings by a neurologist and radiologist, blinded to initial hypotheses.

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Main Results:

  • 85% of patients had findings inconsistent with isolated SSN palsy.
  • 68% exhibited physical signs beyond the SSN distribution.
  • 53% showed EDX abnormalities unrelated to the SSN.
  • 37% had MR evidence of denervation or neural hyperintensity in non-SSN related areas without extrinsic compression.

Conclusions:

  • Most patients with presumed isolated SSN palsy displayed evidence of more widespread neuromuscular involvement.
  • These findings support an inflammatory pathophysiology in numerous cases of "isolated" SSN palsy.