Infraspinatus muscle palsy involving suprascapular nerve, brachial plexus or cervical roots related to inflammatory or mechanical causes: Experience of 114 cases

Electrodiagnostic Assessment of Radiculopathies

This article discusses the electrodiagnostic assessment of radiculopathy. Relevant anatomy initially is reviewed followed by discussion surrounding the approach to nerve conduction studies and needle electrode examination when it comes to radiculopathy evaluation. Pitfalls of the electrodiagnosis versus clinical diagnosis of radiculopathy and the definitions of acute versus chronic, and active versus inactive, are reviewed.

Neuralgic amyotrophy and COVID-19 infection: 2 cases of spinal accessory nerve palsy

OBJECTIVE

Neuralgic amyotrophy (NA), also known as Parsonage-Turner syndrome is often triggered by mechanical stress or upper respiratory tract viral infections. We reported 2 cases of shoulder weakness and amyotrophy related to spinal accessory nerve (SAN) palsy due to neuralgic amyotrophy occurring after COVID-19 infection.

METHODS

For both patients, clinical history, clinical examination, electrodiagnostic (EDX), and imaging examinations invalidated other diagnoses but confirmed NA diagnosis.

RESULTS

The NA involved only the SAN in both cases. EDX revealed a characteristic axonal lesion found in NA. SAN conduction study revealed normal latencies and low compound motor action potential amplitude for trapezius muscle when needle examination demonstrated a neurogenic pattern and denervation signs in the trapezius muscle. Both patient's MRI revealed denervation T2 hypersignal in impaired muscles, and hypersignal of the involved roots, trunks, or nerves without any mass, cyst, injury, fibrous band, or tearing signs along SAN course.

CONCLUSIONS

The COVID-19 infection could be the trigger for NA as many other viruses, and as it is a possible trigger for Guillain-Barré syndrome.