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Isolated Suprascapular Nerve Palsy: a Review of Nine Cases

Published online by Cambridge University Press:  18 September 2015

Henry Berry ,
Kester Kong ,
Alan R. Hudson  and
Richard J. Moulton
Henry Berry*
Affiliation:
Division of Neurology, St. Michael’s Hospital, Toronto
Kester Kong
Affiliation:
Division of Neurology, St. Michael’s Hospital, Toronto
Alan R. Hudson
Affiliation:
The Toronto Hospital, Toronto
Richard J. Moulton
Affiliation:
Division of Neurosurgery, St. Michael’s Hospital, Toronto
*
St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8
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Abstract

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Background

In nine patients, suprascapular nerve palsy followed serious accidents associated with fractures of the cervical vertebrae, clavicle or scapula and after weight lifting, wrestling and a fall on the elbow or shoulder.

Method

All patients were examined as to muscle wasting, weakness and shoulder fixation. EMG examination was done in all cases and six patients underwent surgical exploration.

Results

The palsy was incomplete on clinical and EMG examination in all patients. On exploration, scarring, entrapment, tethering or kinking at the suprascapular notch was found in four and two had post-traumatic neuromas.

Conclusions

In contrast to published studies, none of our patients presented with shoulder pain, a spontaneous onset nor with involvement limited to the infraspinatus muscle. The differential diagnosis should include C5 root lesion, brachial plexus neuritis, frozen shoulder and tear of the rotator cuff.

Résumé

Résumé<span class='italic'><span class='bold'>Introduction</span></span>

Chez neuf patients, la paralysie est apparue suite à un accident grave avec fractures de vertèbres cervicales, de la clavicule ou de l’omoplate, suite à la pratique de l’haltérophilie ou de la lutte, suite à une chute sur le coude ou l’épaule.

<span class='italic'><span class='bold'>Méthode</span></span>

Nous avons vérifié l’atrophie musculaire, la faiblesse et la fixation de l’épaule chez tous les patients. Ils ont tous subi un EMG et six patients ont subi une exploration chirurgicale.

<span class='italic'><span class='bold'>Résultats</span></span>

L’examen clinique et l’EMG ont montré une paralysie incomplète chez tous les patients. L’exploration a mis en évidence du tissu cicatriciel, une séquestration, une fixation ou une coudure du nerf au niveau de l’échancrure coracoïdienne chez quatre patients et deux avaient un neurome post-traumatique.

<span class='italic'><span class='bold'>Conclusions</span></span>

Contrairement aux études déjà publiées, aucun des patients de notre étude ne s’est présenté avec une douleur à l’épaule, une apparition spontanée des symptômes ou une atteinte limitée au muscle sous-épineux. Le diagnostic différentiel de cette affection inclut la lésion de la racine nerveuse C5, la névrite du plexus brachial, l’épaule gelée et la rupture de la coiffe des rotateurs.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 4 , November 1995 , pp. 301 - 304
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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