Ann Rehabil Med.  2013 Feb;37(1):133-137. 10.5535/arm.2013.37.1.133.

Spinal Accessory Neuropathy Associated With the Tumor Located on the Jugular Foramen

• Lee S
• Yang S
• Lee J
• Kim I

• KMID: 2266662
• DOI: http://doi.org/10.5535/arm.2013.37.1.133

Abstract

Spinal accessory neuropathy is commonly caused by iatrogenic injury or secondary to trauma or infection. Nevertheless, the tumor related palsy is rare. We present a case of an 18-year-old male patient suffering from paralysis of his right trapezius and sternocleidomastoid muscle. An electrophysiologic diagnostic study confirmed the spinal accessory neuropathy of the proximal segment. In addition, magnetic resonance imaging showed the location of tumor on the jugular foramen. However, the type of the tumor was not confirmed through biopsy because the patient refused surgical procedure. Based on the study, it is hypothesized that the tumor located on the jugular foramen should be considered as a cause of the spinal accessory nerve of the proximal segment.

Keyword

Accessroy nerve; Glomus jugulare; Neoplasms

MeSH Terms

Accessory Nerve
Biopsy
Glomus Jugulare
Humans
Magnetic Resonance Imaging
Male
Muscles
Paralysis
Stress, Psychological

Figure

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  Fig. 1 Weakness of the shoulder abduction (A) and winging of the right scapula (B).

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  Fig. 2 Electromyography of the right sternocleidomastoid and trapezius muscles. Denervation in the examined muscles with positive sharp waves.

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  Fig. 3 Magnetic resonance imaging of the tumor located on the jugular foramen. (A) On T1-weighted image, the tumor (arrow) shows high signal intensity when compared with brain matter. (B) On T2-weighted image, the tumor (arrow) has low signal intensity when compared with brain matter. (C) Computed tomographic image of the same tumor (arrow) shows smooth expansion of the right jugular foramen.

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  Fig. 4 Follow-up magnetic resonance imaging (MRI) of the tumor (both arrow) located on the jugular foramen. (A) T1-weighted images and (B) T2-weighted images demonstrate no interval changes in the previous findings of the MRI.

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