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Bilateral thoracic outlet syndrome: An uncommon presentation of a rare condition in children.
[thoracic outlet syndrome]
We
report
an
adolescent
girl
who
had
left-sided
neurogenic
thoracic
outlet
syndrome
(
TOS
)
due
to
impingement
of
the
scalenus
anterior
muscle
with
bilateral
changes
on
nerve
conduction
studies
and
responded
well
to
surgical
decompression
.
A
13
-
year
-old
Caucasian
girl
presented
with
intermittent
pain
,
swelling
,
erythema
,
tingling
and
numbness
of
the
palmar
aspect
of
her
left
hand
.
Nerve
conduction
studies
revealed
bilateral
ulnar
sensory
and
motor
conduction
abnormalities
,
suggesting
early
compressive
neuropathy
in
the
asymptomatic
arm
as
well
.
She
underwent
surgical
exploration
when
it
was
noted
that
the
scalenus
anterior
itself
was
impinging
on
the
brachial
plexus
.
She
had
a
good
clinical
response
to
scalenectomy
.
The
diagnosis
of
neurogenic
TOS
remains
difficult
as
no
single
test
has
been
accepted
as
a
gold
standard
.
But
,
once
diagnosed
using
clinical
symptoms
,
nerve
conduction
studies
,
electromyography
and
radiological
investigations
,
it
is
a
treatable
condition
with
good
prognosis
.