Isolated spinal accessory mononeuropathy associated with neurogenic muscle hypertrophy: restricted neuralgic amyotrophy or stretch-palsy? A case report.

[neuralgic amyotrophy]

A 55 -year -old man developed transient bi -brachial paresthesias followed by severe pain over his left shoulder ridge and periscapular region within 8 hours of rigorous hand -over-hand hoisting of a 33 .8 -kg (75 -lb ) object . He experienced weakness in shoulder abduction followed several weeks later by focal hypertrophy of the left trapezius . Electrophysiologic studies showed significant spontaneous motor activity in the form of denervation potentials , fasciculations , and complex repetitive discharges . The 2 major diagnostic considerations were restricted neuralgic amyotrophy versus stretch palsy of the spinal accessory nerve . The clinical similarities and differences between restricted forms of neuralgic amyotrophy and stretch palsies are discussed .