Ehtesham Khalid*, Sana Asghar, Ayesha Malik and Farrukh Gillani
Introduction: Spinal Accessory Nerve (SAN) is a purely motor nerve which innervates the trapezius and sternocleidomastoid muscles. Due to its relatively long and superficial extra cranial course it is vulnerable to damage during neck procedures and trauma. I am presenting a case of SAN injury with near normal recovery due to early detection.
Case presentation: 38-year-old male who noted right shoulder pain after lymph node resection three weeks ago in the right posterior triangle of neck. On examination, there was atrophy of right trapezius muscle and loss of bulk in right supra-scapular fossa. Nerve conduction study showed reduced Compound Muscle Action Potential (CMAP) on right side compared to left side with active denervation changes to confirm the diagnosis. Patient had nerve repair with improvement in pain and muscle bulk. Repeat nerve conduction study showed interval improvement in CMAP.
Discussion: SAN injuries are difficult to diagnose but timely diagnosis and management in experienced hands is crucial in such cases and can show promising results.
