Accessory Nerve Palsy: A Review of 23 Cases

Abstract

In a series of 23 patients, the commonest cause of accessory nerve palsy was surgical trauma at the time of lymph node biopsy. The less common causes were penetrating or blunt trauma and a few were of spontaneous onset. There was involvement of adjacent motor sensory nerves in about half of the patients. The prognosis was better following blunt trauma, stretch injuries and after a spontaneous onset. The anatomical relationships of the accessory nerve and aspects of the clinical picture and management are discussed. RESUME: Paralysie du nerf spinal: revue de 23 cas. Dans une serie de 23 patients, la cause la plus frequente de paralysie du nerf spinal 6tait le traumatisme chirurgical au moment d'une biopsie d'un ganglion lymphatique. Parmi les causes plus rares, on notait les traumatismes penetrants ou contondants et quelques ces etaient spontanes. II existait une atteinte des nerfs moteurs ou sensitifs adjacents chez a peu pres la moitie des patients. Le pronostic etait plus favorable a la suite des traumatismes contondants, des blessures par 6tirement et lorsque le debut etait spontane. Nous discutons des relations anatomiques du nerf spinal, de certains aspects du tableau clinique et de la conduite du traitement.Can. J. Neurol. Sci. 1991; 18:337-341 Accessory nerve palsy commonly occurs as a result of a surgical trauma within the posterior triangle, 1 -2 -3 -4 -5 usually at the time of lymph node excision. 6 -7 -8 -9 It has also been described following carotid endarterectomy, 10 -11 accidental laceration, 7 irradiation 12 and as a spontaneous event. 13 This series is unusual as it contains a relatively large number of cases in which the trauma was of a non-surgical type.

Accessory nerve lesion after cervicofacial lift: Clinical and electrodiagnostic evaluations of two cases

“…[1][2][3][5][6][7][8][9][10]12,13,[17][18][19][21][22][23][24] The AN has a double origin in the XIth cranial nerve and a part of the first three cervical roots. 4,12,15,19,21 After exiting the skull through the jugular foramen, it divides into a medial branch that coalesces with the vagus nerve and a lateral purely motor branch that supplies the sternocleidomastoid and trapezius muscles (TMs).…”

Spinal Accessory Nerve Palsy: Associated Signs and Symptoms

“…40 Spinal accessory nerve injury commonly occurs during neck dissection surgery. 2,6,9,11,[13][14][15][27][28][29]31,43,46,48,49,52,53 Neck dissection surgery is performed to treat head and neck carcinoma and is categorized into 3 different procedures: radical S pinal accessory nerve palsy (SANP) is common following neck dissection surgery or lymph node excision, 2,6,9,11,[13][14][15][27][28][29]31,43,46,48,49,52,53 blunt or penetrating trauma to the lateral neck region, 2,11 and cervical stretch injuries. 32 Spinal accessory nerve injury results in trapezius paralysis or dysfunction and a diagnostic cluster of signs and symptoms, including shoulder girdle depression, trapezius atrophy, scapular dyskinesis, loss of shoulder STUDY DESIGN: Retrospective case series.…”

Spinal Aksesuar Sinir Felci: Dört Atipik Hastanın Değerlendirilmesi

“…All segments of the trapezius muscle were affected in the three cases (1, 2, 4). Only the upper segment was affected in one case (3). A similar case of a patient with only upper segment paresis due to accessory nerve palsy has been reported (13).…”

“…Anah tar Ke li me ler: Aksesuar sinir felci, trapez kası, gerilme yaralanması, sinir iletimi, nöropatik ağrı Introduction Isolated accessory nerve palsy is a rare focal neuropathy. The majority of spinal accessory nerve lesions occur after lymph node biopsy and tumor resection in the posterior cervical triangle (1)(2)(3)(4)(5)(6)(7). Other etiologies include blunt trauma, irradiation, penetrating injury, vascular ectasia, carotid endarterectomy, cardiac surgery, laceration, compression, strenuous weight lifting, whiplash, spontaneous palsy (idiopathic) due to plexitis, and other more rare occasions (3)(4)(5)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

“…In majority of cases with accessory nerve palsy, the trapezius is the only muscle involved, because most injuries occur below the level of supply to the sternocleidomastoid muscle (3,4,23).…”