Spinal Accessory Nerve Palsy: Associated Signs and Symptoms

Study Design Retrospective case series. Background Spinal accessory nerve palsy (SANP) is common following neck dissection surgery and can occur with blunt or penetrating trauma to the lateral neck region and cervical stretch injuries. Early detection of SANP remains a clinical challenge and the condition is often misdiagnosed. The purpose of this case series is to describe the associated history, signs, and symptoms related to SANP and increase awareness of the scapular flip sign as a clinical sign associated with SANP. Case Series Description Twenty subjects (13 male, 7 female) presented with pain and decreased shoulder function following head and neck surgery or posttrauma. All patients were thoroughly examined and the scapular flip sign was assessed. All patients presented with a cluster of signs and symptoms, including trapezius atrophy, shoulder girdle depression, limited active shoulder abduction to less than 90°, shoulder pain, and shoulder weakness. A positive scapular flip sign was present in al...