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Collet-Sicard syndrome mimicking neuralgic amyotrophy
W L Larson1, A Beydoun, J W Albers
1Department of Neurology, University of Michigan Medical Center, Ann Arbor 48109, USA.
Muscle & Nerve
|September 1, 1997
Summary
A patient presented with shoulder pain and cranial nerve issues. Further investigation revealed Collet-Sicard syndrome caused by an occipital condyle mass, highlighting the importance of focal lesion identification.
Area of Science:
- Neurology
- Oncology
- Diagnostic Imaging
Background:
- Neuralgic amyotrophy can present with cranial nerve palsies.
- Collet-Sicard syndrome involves cranial nerves IX, X, XI, and XII.
- Differential diagnosis is crucial for complex neurological presentations.
Observation:
- A patient exhibited shoulder pain, muscle wasting, and weakness with ipsilateral cranial nerve abnormalities.
- Initial electrodiagnostic studies suggested neuralgic amyotrophy.
- Subsequent evaluation identified spinal accessory mononeuropathy and hypoglossal nerve weakness, indicative of Collet-Sicard syndrome.
Findings:
- Magnetic resonance imaging revealed an inaccessible mass at the occipital condyle.
- Disseminated adenocarcinoma was diagnosed as the underlying cause.
- The case highlights the importance of identifying focal lesions in neurological deficits.
Implications:
- This case underscores the necessity of thorough investigation beyond initial diagnoses like neuralgic amyotrophy.
- It emphasizes the diagnostic value of electrodiagnosis in localizing neurological deficits.
- Recognizing focal lesions is critical for accurate diagnosis and management of complex neurological conditions, including cancer metastasis.