Parasympathetic nerve injury and entrapment



OVERVIEW

Overview of the Parasympathetic Nerve

The parasympathetic nerves are the 11th pair of cerebral nerves, consisting of cerebral nerves and spinal cord nerve roots, which mainly innervate the trapezius and sternocleidomastoid muscles. A variety of reasons can lead to paralysis and paralysis of the trapezius muscle, causing certain deformities and serious dysfunction, often affecting the movement of the shoulder on the affected side and leading to muscle atrophy.

Whether medical insurance

yes

Department

Neurology, Neurosurgery, Orthopedics, Hand Surgery

Clinical symptoms

Shoulder abduction and supination cannot exceed 90°, trapezius muscle atrophy, shrug disorder, etc.

Harmful effects

Affecting shoulder movement, causing dull shoulder pain, radiating pain in the arm, causing inconvenience to normal life and work.

Examination

Physical examination, CT, MRI, electromyography, etc.

Diagnosis

Diagnosis can be made on the basis of medical history, clinical manifestations such as shoulder pain and limitation of movement, combined with imaging examination.

Treatment principle

Neurotrophic treatment or surgical treatment.

Curability

The damage can be repaired to a certain extent and the entrapment can be loosened.

Dietary advice

Reasonable diet and balanced nutrition.

Etiology

Etiology

Caused by tumor or fracture at the base of the skull, congenital anomalies of the cervicocranial junction, and surgical malpractice of the neck.

Symptoms and Diagnosis

Typical symptoms

Symptoms mainly include paralysis of the trapezius muscle, such as shoulder droop, shoulder abduction cannot reach the horizontal position, shoulder joint activity is limited, the affected shoulder cannot be lifted up more than 90° in abduction, and shrugging is impaired; the trapezius muscle atrophies, while the scapularis muscle attached to the upper angle of the scapula contracts and raises the position of the inner angle of the scapula, which results in the elevation of the posterior margin of the supraclavicular fossa, and the supraclavicular fossa deepens significantly.

Other symptoms

Some patients present with a dull shoulder pain that radiates to the arm. Paralysis of the sternocleidomastoid muscle and head-turning disorder may also occur.

Diagnostic basis

1. History of injury, fracture, tumor, etc., and clinical manifestations such as limited shoulder movement.

2. Electromyography can show loss of nerve, MRI, CT and other imaging tests can help to diagnose the cause of the disease.

Treatment

Treatment guidelines

Surgical treatment to repair the damage of the parasympathetic nerve and loosen the parasympathetic nerve entrapment.

Surgical treatment

Treatment is chosen according to the severity and duration of symptoms. In early stages of parasympathetic nerve injury or entrapment, nerve repair and release are possible. In advanced cases with significant shoulder discomfort, surgical treatment to stabilize the shoulder joint, such as scapulothoracic fusion and scapular fixation, may be considered.

Prognosis

If the various etiologies of paraspinal nerve injury and entrapment can be relieved and the dissected nerve can be reconstructed, paraspinal nerve function can be restored to a certain extent.

Nursing care

Daily care

Strengthen functional exercise to promote nerve recovery.

Maintain a calm state of mind, stop being anxious and impatient, and take active treatment.

Follow the doctor’s instructions, take medication on time, and have regular checkups.

Diet

Eat a reasonable diet with balanced nutrition and avoid drinking alcohol.