Bilateral musculocutaneous neuropathy: A case report

Area of Science:

• Neurology
• Sports Medicine
• Anatomy

Background:

• Isolated musculocutaneous nerve injury is uncommon.
• This report details the first known case of bilateral musculocutaneous neuropathy following strenuous bilateral upper extremity stretching exercises.
• The condition presented with normal sensory nerve action potential results, complicating initial diagnosis.

Observation:

• A 29-year-old male experienced bilateral forearm tingling and upper extremity weakness.
• Previous extensive investigations, including imaging and electrodiagnostic studies, were inconclusive.
• The patient's symptoms were linked to unique exercises involving stretching of the pectoralis minor and coracobrachialis muscles.

Findings:

• Follow-up electrodiagnostic studies revealed abnormal spontaneous activities in the bilateral biceps and brachialis muscles.
• The patient was diagnosed with bilateral musculocutaneous neuropathy.
• Treatment with approximately 6 weeks of steroid pulse therapy resulted in a full recovery of muscle strength.

Implications:

• This case underscores the need for clinicians to be aware of bilateral musculocutaneous neuropathy as a potential diagnosis.
• A thorough understanding of upper extremity anatomy is crucial for accurate diagnosis and management.
• Patients should be advised to correct potentially harmful stretching exercises to prevent nerve injury.