Paul Seror1,2, Tanya Stojkovic3, Marie Martine Lefevre-Colau4, Timothée Lenglet2. 1. 146 Laboratoire d'électroneuromyographie, Av. Ledru Rollin, 75011, Paris, France. 2. Département de Neurophysiologie Clinique, Hôpital de la Pitié-Salpétrière, Paris, France. 3. Unité clinique de Pathologie Neuromusculaire, Institut de Myologie. Hôpital Pitié-Salpêtrière, Paris, France. 4. Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, APHP, Université Paris Descartes, PRES Sorbonne Paris Cité, ECaMO team, INSERM UMR-S 1153 et Institut Fédératif de Recherche sur le Handicap, Paris, France.
Abstract
INTRODUCTION: We assessed medical and surgical causes of unilateral trapezius muscle (TM) palsy and/or wasting. METHODS: Clinical and electrodiagnostic data were collected in 54 patients with TM impairment over 21 years. RESULTS: In total, 35 cases had a medical origin: neuralgic amyotrophy (NA, n = 22), idiopathic unilateral TM palsy (n = 5), regional neck radiotherapy for different conditions (n = 2), facioscapulohumeral dystrophy (FSH) (n = 4), abnormal loop of the jugular vein (n = 1), or basilar impression (n = 1). Other etiologies were neck surgery (n = 16), cervicofacial lift (n = 2), or trauma (n = 1). CONCLUSIONS: There were 5 main diagnostic findings in unilateral TM palsy: (1) dynamic examination of the scapula provides a new clinical sign; (2) NA is the most frequent medical cause; (3) in medical cases, partial preservation of the upper TM can offer good recovery; (4) FSH must be considered, especially in young patients; and (5) minor neck surgery can lead to severe TM palsy. Muscle Nerve 56: 215-223, 2017.
INTRODUCTION: We assessed medical and surgical causes of unilateral trapezius muscle (TM) palsy and/or wasting. METHODS: Clinical and electrodiagnostic data were collected in 54 patients with TM impairment over 21 years. RESULTS: In total, 35 cases had a medical origin: neuralgic amyotrophy (NA, n = 22), idiopathic unilateral TM palsy (n = 5), regional neck radiotherapy for different conditions (n = 2), facioscapulohumeral dystrophy (FSH) (n = 4), abnormal loop of the jugular vein (n = 1), or basilar impression (n = 1). Other etiologies were neck surgery (n = 16), cervicofacial lift (n = 2), or trauma (n = 1). CONCLUSIONS: There were 5 main diagnostic findings in unilateral TM palsy: (1) dynamic examination of the scapula provides a new clinical sign; (2) NA is the most frequent medical cause; (3) in medical cases, partial preservation of the upper TM can offer good recovery; (4) FSH must be considered, especially in young patients; and (5) minor neck surgery can lead to severe TM palsy. Muscle Nerve 56: 215-223, 2017.