AANEM Connect
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Spinal Accessory Palsy
I saw a 43 y/o woman with right neck and shoulder atrophy after surgical excision of a upper cervical mass in June 2021. Needle evaluation shows decreased insertional activity and no recruitment of motor units in the trapezius and SCM, except for two MUAPs seen in the upper trapezius. No abnormal spontaneous activity was seen. Other scapular muscles were normal. Ultrasound evaluation confirms marked atrophy and hyperechoic texture changes localized to these muscles. Presentation seems consistent with near complete loss of spinal accessory nerve function.
Is this a diagnosis that may benefit from peripheral nerve surgery? If so, are there any centers that can evaluate for this. Location is Spokane but I'd imagine this patient would be willing to travel.
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