We have experienced two cases of entrapmentneuropathy of the suprascapular nerve in three accessory nerve palsy.
CASES. Three patients were refered to our clinic because of a dropped shouldor, inability to abduct the shoulder, and wasting of the upper trapezius. Among those, two cases showed moderate to severe pain in the shoulder region which was inproportionally strong as part of the symptoms of accessory nerve palsy.
Case 1: A 28-year-old woman had a biopsy of the neck which was followed by increasing pain in the shoulder region. Five menths after the biopsy, an abduction support was employed to prevent dropping of the shoulder girdle. The symptoms gradually alleviated within five months after the abduction support had been applied.
Case 2: A biopsy in the neck of a 23-year-old woman was followed by severe pain in the shoulder region. Five months after the biopsy, an accessory nerve was sutured, and the suprascapular transverse ligament was excised to decompress the suprascapular nerve. Five days after the operation, the pain in the shoulder was decreased dramatically.
Discussion: On the basis of our experiences, entrapment neuropathy of the suprascapular nerve occurs at the scapular notch, having been presumably caused by insufficiency of the upper trapezius due to accessory nerve palsy. We conclude that this is one of the pathogenesis of the unexplained pain in the shoulder region caused by accessory nerve palsy.
