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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
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Related Experiment Video

Updated: Jan 13, 2026

Author Spotlight: Minimally Invasive Relief for Occipital Neuralgia at the Nuchal Line
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Non-iatrogenic spinal accessory nerve palsy due to lymph node compression.

Ines Oliveira Pires1, Bernardo Cavadas2, Gerardo Millan3

  • 1Plastic and Reconstructive Surgery, ULS São José, Lisbon, Lisbon, Portugal ipires@campus.ul.pt.

BMJ Case Reports
|January 7, 2026
PubMed
Summary

Spinal accessory nerve (SAN) palsy can occur from enlarged lymph nodes compressing the nerve. This case highlights a rare, non-traumatic cause of SAN palsy in an adolescent, leading to successful surgical treatment.

Keywords:
Anatomic VariationHead and neck surgeryPlastic and reconstructive surgerySurgerySurgical Procedure, Operative

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Area of Science:

  • Neurology
  • Surgical Anatomy

Background:

  • Spinal accessory nerve (SAN) injuries are typically iatrogenic or traumatic.
  • SAN palsy from lymph node compression is rare and often linked to malignancy or surgery.

Purpose of the Study:

  • To report a rare case of SAN palsy caused by lymph node compression in an adolescent.
  • To highlight a non-iatrogenic, non-traumatic etiology for SAN palsy.

Main Methods:

  • Case report of an adolescent with spontaneous shoulder asymmetry.
  • Surgical exploration revealing SAN compression by enlarged lymph nodes.
  • Neurolysis of the spinal accessory nerve.

Main Results:

  • The patient presented with clinical signs of SAN palsy without prior trauma or surgery.
  • Enlarged lymph nodes were found to be compressing the SAN.
  • Neurolysis resulted in significant clinical improvement.

Conclusions:

  • Enlarged lymph nodes represent a rare cause of SAN palsy.
  • This case expands the understanding of non-iatrogenic SAN injury.
  • Prompt diagnosis and surgical intervention can lead to favorable outcomes.