A case of neuralgic amyotrophy presented Vernet syndrome and suprascapular nerve palsy

Abstract

A 54 year-old-man had pain and stiffness at the left hind neck. One month later, dysphagia, hoarseness, atrophy, and weakness of left shoulder muscles appeared. Neurological and neurophysiological examination revealed left IX, X, XI cranial (Vernet syndrome) and ipsilateral suprascapular nerves were disabled. Major causes of Vernet syndrome, jugular foramen lesions, were not identified by comprehensive imaging studies. VZV and other infectious diseases were excluded by serological tests. Immunotherapy alleviated the large part of his symptoms including supra/infraspinatus muscle strength. Although brachial plexus involvement was minimal, this case was consistent with neuralgic amyotrophy. We would suggest examining the ipsilateral limb and girdle muscles of a patient in Vernet syndrome with the unknown cause.