[Neurological shoulder pain and weakness : practical attitudes].

Area of Science:

• Neurology
• Orthopedics
• Physical Medicine and Rehabilitation

Background:

• Shoulder pain and paresis have diverse etiologies, encompassing osteoarticular, degenerative, inflammatory, and neurological origins.
• Cervicobrachialgia, plexitis, and focal mononeuropathy are potential causes of shoulder weakness and pain.
• Identifying muscular or mechanical origins is crucial for understanding pseudo-paretic functional limitations.

Purpose of the Study:

• To outline the diagnostic approach for shoulder pain and paresis.
• To emphasize the identification of neurogenic scapulalgia and nerve entrapment syndromes.
• To review the common etiologies and management strategies for shoulder dysfunction.

Main Methods:

• Clinical assessment to identify the origin of paresis and functional limitation.
• Diagnostic evaluation including nerve conduction studies (NCS) and myography.
• Medical imaging to aid in identifying the underlying etiology of neurogenic scapulalgia.

Main Results:

• Neurogenic scapulalgia often results from compression or entrapment of shoulder girdle nerves (axillary, long thoracic, accessory, suprascapular, dorsal scapular).
• A combination of electrodiagnostic tests and imaging is effective in determining the cause of shoulder dysfunction.
• Most cases are successfully managed non-surgically.

Conclusions:

• Comprehensive evaluation is essential for accurate diagnosis of shoulder pain and paresis.
• Nerve conduction studies, myography, and imaging are vital for diagnosing nerve-related shoulder conditions.
• Conservative management, including pain relief and physiotherapy, is the mainstay treatment for most patients.