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Stretch-induced spinal accessory nerve palsy.

E L Logigian1, J M McInnes, A R Berger

  • 1Clinical Neurophysiology Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston.

Muscle & Nerve
|February 1, 1988
PubMed
Summary
This summary is machine-generated.

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Sudden head turning with heavy objects caused left spinal accessory nerve palsy. Electrophysiology revealed partial and complete nerve damage, affecting key shoulder and neck muscles.

Area of Science:

  • Neurology
  • Anatomy
  • Physiology

Background:

  • Spinal accessory nerve (SAN) palsy can result from various injuries.
  • Understanding the specific nerve branches and their functions is crucial for diagnosis and treatment.

Observation:

  • A young man developed left SAN palsy after rapidly turning his head right while carrying heavy objects.
  • This action subjected the neck and shoulder structures to significant mechanical stress.

Findings:

  • Electrophysiologic studies indicated partial axonotmesis in SAN branches supplying the sternocleidomastoid and upper/middle trapezius.
  • Complete axonotmesis was observed in branches to the lower trapezius.
  • A minor cervical plexus contribution to lower trapezius innervation was noted.

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Implications:

  • This case highlights a potential mechanism for acute SAN injury due to combined head and shoulder movement.
  • The findings underscore the differential vulnerability of SAN branches to traction injuries.
  • Knowledge of accessory and cervical plexus innervation is important for evaluating trapezius function post-injury.