SpontanGelişen İzoleAxiller Sinir Lezyonu

68 yaşındaki, avukat erkek hasta 3 ay önce sol omuzda gelişen ağrı ve güçsüzlük şikayetiyle polikliniğimize başvurdu.Hastanın ilk muayenesinde omuz abduksiyon kas gücü 0/5 idi. Diğer kas güçleri ve nörolojik muayenesi normaldi. Anemnezinde herhangi bir travma ve tekrarlayıcı spor aktivitesi tariflemiyordu. EMG si sol axiller sinirin ağır aksonal hasarı, sol elde hafif-orta derecede karpal tünel sendromu olarak rapor edildi. Akut gelişen şiddetli omuz ağrısı ve güçsüzlüğü gelişen hastalarda izole axiller sinir lezyonu akla gelmelidir. Ayırıcı tanıda travma tariflemeyen hastalarda nevraljik amyotrofi, vaskülit ve lokalize nörit düşünülmelidir

IsolatedAxillaryNerveLesionOccuring Spontaneously

68-year-old patient who is lawyer admitted to our clinic because of occuring weakness and pain on the left shoulder 3 months ago. His abductor muscle strength of left shoulder was 0/5 in the first examination. The strenght of other muscles and neurological examinations were normal. He did not describe any trauma and repetitive sport activities in the anamnesis. EMG was reported as severe axonal damage of the left axillary nerve and mild to moderate carpal tunnel syndrome. Isolated axillary nerve palsy should be kept in mind in patients with acute severe shoulder pain and weakness Neuralgic amyotrophy,vasculitis, localized neuritis should be considered in the differential diagnosis in patients who dont describe any trauma

PDF

___

1. Guveli BT, Aysal F, Gursoy AE, et al. İzole aksiller sinir tutulumu: Olgu sunumu. The Journal of Psychiatry and Neurological Sciences 2013; 26: 211-14.
2. Leffert RD, Seddon HJ. Intraclavicular brachial plexus lesions. J Bone Joint Surg 1965; 47(1): 9-22.
3. Blom S, Dahlback LD. Nerve injuries in dislocations of the shoulder joint and fractures of the neck of the humerus. Acta Chir Scand 1970; 136: 461-6.
4. Kirby JF, Kraft GH. Entrapment neuropathy of anterior branch of axillary nerve; report of case. Arch Phys Med Rehab 1972; 53: 383-7.
5. Henry Berry, Vera Brıl. Axillary nerve palsy following blunt trauma to the shoulder region: a clinical and electrophysiological review. J Neurol Neurosurg Psychiatry. 1982; 45: 1027-32.
6. Paladini D, Dellantonio R, Cinti A, et al. Axillary neuropathy in volleyball players: report of two cases and literature review. J Neurol Neurosurg Psychiatry 1996; 60: 345-7.
7. Bonnard C, Anastakis DJ, van Melle G, et al. Isolated and combined lesions of the axillary nerve. J Bone Joint Surg Br 1999; 81: 212-7.
8. Goslin KL, Krivickas LS. Proximal neuropathies of the upper extremity. Neurol Clin 1999; 17: 525-45
9.Smith CC, Bevelaqua AC. Challenging pain syndromes: Parsonage-Turner syndrome. Phys Med Rehabil Clin N Am 2014; 25(2): 265-77.
10.Mamula CJ, Erhard RE, Piva SR. Cervical radiculopathy or Parsonage-Turner syndrome: differential diagnosis of a patient with neck and upper extremity symptoms. J Orthop Sports Phys Ther 2005 ;35(10): 659-64.