Isolated Axillary Nerve Involvement: A Case Report

Headnote

ABSTRACT

Isolated axillary nerve involvement a case report

Isolated axillary neuropathy is a rare condition. Trauma to the shoulder, especially dislocation of the shoulder is the most common cause. The other causes of axillary neuropathy are injection to the shoulder, carrying heavy backpacks and acute idiopathic brachial plexus neropathy. Differential diagnosis should be made especially between cervical 5-6 radiculopathy and upper truncus brachial plexopathy.

Case: A 32-year-old man admitted with progressive atrophy and weakness of the right shoulder which developed after deep pain. In his neurological examination, abduction weakness and atrophy of the right shoulder was determined. Magnetic resonance imaging findings of cervical spine and right shoulder were normal. Electrophysiologic examination revealed reduced compound muscle action potential amplitude of the right axillary nerve, recorded from deltoid muscle, compared to the left side. On needle EMG, subacute neurogenic signs in the right deltoid and teres minor muscles which are innervated by the axillary nerve were detected. Etiological evaluation revealed no cause. It has been suggested that isolated axillary neuropathy may be associated with Personage-Turner syndrome. Antiinflammatory medications and physical therapy provided partial improvement The aim of our presentation was to discuss the differential diagnosis, treatment options and etiologic causes of axillary neuropathy.

Key words: Axillary nerve, acute idiopathic brachial plexus neuropathy, EMG

ÖZET

izole aksiller sinir tutulumu: Olgu sunumu

izole aksiller sinir tutulumu nadir görülen birdurumdur. En sik karçilaçilan neden omuz travmasi, özellikle omuz çikigidir. Omuza ya pilan enjeksiyon, sirt çantasi kullanimi veya akut idiyopatik brakiyal pleksus nöropatisi diger etiyolojik nedenlerolabilir. C5/C6 radikülopati, brakiyal pleksus üsttruηkus tutulumu ile ayirici tanisi yapilmalidir.

Olgu: Sag omuzda çiddetli agri sonrasi gûçsûzlûk ve incelme gelten, nörolojik muayenede sag omuz abdüksiyon zaafi ve atrofisi oían 32 ya^indaki erkek hastanin servikal spinal ve omuz MR incelemeleri normaldi. Elektrofizyolojik incelemede, sag aksiller sinir bileçik kas aksiyon potansiyeli, deltoid kasindan kayitlama ile sola göre dïiçïiktïi. igne elektromiyografisinde aksiller sinir inervasyonlu deltoid ve teres minor kaslarinda subakut dönem nörojenik tutulum bulgulari saptandi. Etiyolojik araçtirmada neden bulunamadi. izóle aksiller sinir tutulumunun Personage-Turner Sendromuna bagli olabilecegi dü^ünüldü. Antienflamatuar ilaçlar ve fizik tedavi ile hasta kismen düzeldi. Vaka; ayirici tani, tedavi ve etiyolojik nedenleri tartiçmak amaci ile sunuldu.

Anahtar kelimeler: Aksiller sinir, akut idiyopatik brakiyal pleksus nöropatisi, EMG

INTRODUCTION

The axillary nerve is comprised of fibers...