External branch spinal nerve paralysis on keloid scar
Samia Frioui, Faycel Khachnaoui
The Pan African Medical Journal. 2016;24:12. doi:10.11604/pamj.2016.24.12.9354

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External branch spinal nerve paralysis on keloid scar

Cite this: The Pan African Medical Journal. 2016;24:12. doi:10.11604/pamj.2016.24.12.9354

Received: 15/03/2016 - Accepted: 29/03/2016 - Published: 04/05/2016

Key words: Spinal nerve, paralysis, EMG, surgery

© Samia Frioui et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/24/12/full

Corresponding author: Samia Frioui, Service de Médecine Physique et de Réadaptation Fonctionnelle, CHU Sahloul Sousse, Faculté de Médecine Ibn El Jazzar, Sousse, Tunisie (soumaf1975@yahoo.fr)


External branch spinal nerve paralysis on keloid scar

Samia Frioui1,&, Faycel Khachnaoui1

 

1Service de Médecine Physique et de Réadaptation Fonctionnelle, CHU Sahloul Sousse, Faculté de Médecine Ibn El Jazzar, Sousse, Tunisie

 

 

&Corresponding author
Samia Frioui, Service de Médecine Physique et de Réadaptation Fonctionnelle, CHU Sahloul Sousse, Faculté de Médecine Ibn El Jazzar, Sousse, Tunisie

 

 

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The paralysis of the external branch of spinal nerve is very rare. It manifests clinically by a weakness and abnormal morphology of the shoulder. We must think about it in front of any simple surgery of the cervical region. We report the case of a 20 year old patient, who consulted several doctors for pain and progressive weakness of the left shoulder appeared a few days after resumption of a keloid scar complicating surgical excision of a cervical lipoma operated some months earlier. Physical examination revealed a strength of the left shoulder listed on 3 without articular limitation, atrophy of the trapezius muscle with ipsilateral asymmetry and fall of the left shoulder. A lesion of spinal nerve was suspected and an EMG was executed. The EMG objectified a partial lesion of the left spinal Nerve. The patient was sent in Plastic and Reconstructive surgery for nerve repair. The achievement of the external branch of spinal nerve is manifested by pain and weakness in the shoulder triggered by the anteflexion movements of the upper limb. The most usual cause is cervical lymph node biopsy. In our case, the spinal nerve lesion occurred while the resumption in keloid skin scar. This is explained by the very superficial location of the Spinal Nerve.

 

 

Figure 1: (A) scar causing paralysis of the external branch of the left spinal nerve; (B) drop left shoulder front view; (c) drop left shoulder back view; (D) peeling off of the left scapula at the shoulder antepulsion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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