Ann Rehabil Med.  2011 Aug;35(4):565-569. 10.5535/arm.2011.35.4.565.

True Neurogenic Thoracic Outlet Syndrome Following Hyperabduction during Sleep: A Case Report

  • 1Department of Physical and Rehabilitation Medicine, Korea University College of Medicine, Ansan 425-707, Korea.
  • 2Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Ansan 425-707, Korea.
  • 3Department of Radiology, Korea University College of Medicine, Ansan 425-707, Korea.


True neurogenic thoracic outlet syndrome (TOS) is an uncommon disease and is difficult to diagnose at the early stage and then completely cure. We experienced a case of true neurogenic TOS with typical clinical symptoms and electrophysiologic findings as a result of repetitive habitual sleep posture. A 31-year-old woman who had complained of progressive tingling sensation on the 4th and 5th fingers with shoulder pain was diagnosed of brachial plexopathy at the lower trunk level by electrodiagnostic studies. There was no other cause of brachial plexopathy except her habit of hyperabduction of shoulder during sleep. This case demonstrated that the habitual abnormal posture can be the only major cause of neurogenic TOS. It is of importance to consider TOS with the habitual cause because simple correction of the posture could stabilize or even reverse disease progress.


Thoracic outlet syndrome; Neurogenic; Hyperabduction sleep
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