Bilateral musculocutaneous nerve palsy. A case report

Area of Science:

• Neurology
• Orthopedic Surgery
• Clinical Case Study

Background:

• Musculocutaneous nerve palsy can result from various etiologies, impacting upper limb function.
• Isolated, proximal involvement of the musculocutaneous nerve is relatively uncommon.
• Understanding treatment efficacy for this specific nerve injury is crucial for patient outcomes.

Observation:

• A patient presented with bilateral, isolated, proximal musculocutaneous nerve palsy.
• Electromyography confirmed complete denervation of biceps brachii, brachialis, and coracobrachialis muscles.
• Nerve conduction studies showed no initial evoked potentials in the musculocutaneous nerves.

Findings:

• Surgical intervention included resection with end-to-end anastomosis on the left and neurolysis without resection on the right.
• Both surgical approaches resulted in significant bilateral functional recovery.
• The side treated with neurolysis without resection demonstrated faster and more complete recovery.

Implications:

• Neurolysis without resection may be a superior surgical strategy for proximal musculocutaneous nerve palsy.
• This case highlights the potential for successful functional restoration in severe nerve injuries.
• Further research into surgical techniques for peripheral nerve repair is warranted.