2023 Volume 51 Issue 6 Pages 645-650
The case was of a 26-year-old woman who worked in the poultry farming industry. Being concerned about the effect of her sedentary lifestyle on her health, she started going to a gym. One day, four months later, the gym was crowded, and her trainer was absent, so she performed only bench presses (10 kg, 20 sets, as usual) without doing warm-up exercises first, and then went home. The next morning, she experienced severe pain from her posterior neck to shoulder and lateral chest on the right. The pain gradually subsided, but the heaviness from the right shoulder to lateral chest persisted, especially when she raised her right arm. She visited our department seven months after the pain began. She had a right winged scapula and atrophy of the right serratus anterior muscle. Nerve conduction study of the long thoracic nerves revealed lower amplitude of compound muscle action potentials in the right serratus anterior muscle than in the left, and needle electromyography of the right serratus anterior muscle showed findings of early reinnervation. There were no notable abnormalities in other muscles. She was diagnosed with neuralgic amyotrophy presenting isolated right long thoracic nerve palsy and was treated conservatively. Even 27 months after the onset of pain, she still felt the heaviness from the right shoulder to lateral chest when she raised her right arm. Electrophysiological examinations were useful in confirming that neuralgic amyotrophy in our case presented isolated palsy of the right long thoracic nerve.
