Bilateral musculocutaneous neuropathy: A case report

BACKGROUND Isolated musculocutaneous nerve injury is a rare condition. Herein, we report the first case of bilateral musculocutaneous neuropathy after vigorous stretching of both upper extremities with normal results of sensory nerve action potential. Clinicians should be aware of this rare condition that can appear bilaterally. In addition, the interpretation of the aberrant electrodiagnostic study results of this case was discussed. CASE SUMMARY A 29-year-old male complaining of bilateral forearm tingling and upper extremity weakness visited the outpatient clinic. The symptoms began 6 mo prior, and he visited another hospital before visiting our department. The diagnosis was not made even after cervical spine magnetic resonance imaging, electrodiagnostic study, brain magnetic resonance imaging, and arteriography were conducted. The patient performed unique exercises that stretched the pectoralis minor and coracobrachialis muscles. On the follow-up electrodiagnostic study, abnormal spontaneous activities in the bilateral biceps and brachialis muscles were observed. The patient was diagnosed with bilateral musculocutaneous neuropathy. Steroid pulse therapy was administered for approximately 6 wk. After treatment, his muscle strength returned to the predisease condition. CONCLUSION Clinicians should be aware of this condition, have adequate understanding of anatomy, and advise to correct inappropriate exercises.

[1]  J. Kissel,et al.  Isolated musculocutaneous neuropathy: a case report. , 2019, The Journal of the Canadian Chiropractic Association.

[2]  I. Ilayperuma,et al.  Coracobrachialis muscle: morphology, morphometry and gender differences , 2016, Surgical and Radiologic Anatomy.

[3]  T. Chabra,et al.  Case Report on Isolated Musculocutaneous Nerve Injury Following a Wrestling Match , 2015 .

[4]  M. Kiernan,et al.  Nerve conduction studies. , 2011, Australian family physician.

[5]  D. Bonthius,et al.  Isolated Musculocutaneous Neuropathy in an Adolescent Baseball Pitcher , 2011, Journal of child neurology.

[6]  K. Merrell,et al.  A Variation of Musculocutaneous Neuropathy: Implications for Electromyographers , 2010, PM & R : the journal of injury, function, and rehabilitation.

[7]  V. Castellano,et al.  Musculocutaneous Neuropathy: Case Report and Discussion , 2010, HSS Journal.

[8]  J. Keel,et al.  Musculocutaneous nerve injury after simulated freefall in a vertical wind-tunnel: a case report. , 2007, Archives of physical medicine and rehabilitation.

[9]  K. Abbed,et al.  CERVICAL RADICULOPATHY: PATHOPHYSIOLOGY, PRESENTATION, AND CLINICAL EVALUATION , 2007, Neurosurgery.

[10]  J. Maris,et al.  Isolated musculocutaneous nerve palsy after heavy physical activity , 2005 .

[11]  C. Yılmaz,et al.  Traumatic musculocutaneous neuropathy: a case report , 2005, Archives of Orthopaedic and Trauma Surgery.

[12]  M. Pećina,et al.  Musculocutaneous nerve entrapment in the upper arm , 2004, International Orthopaedics.

[13]  G. Fuller,et al.  FOCAL PERIPHERAL NEUROPATHIES , 2003, Journal of neurology, neurosurgery, and psychiatry.

[14]  P. McCrory,et al.  Flail arms in a parachutist: an unusual presentation of hereditary neuropathy with liability to pressure palsies , 2002, British journal of sports medicine.

[15]  M. Zwarts,et al.  Peripheral Nervous System's Reaction to Injury , 2002 .

[16]  S. Bird,et al.  Nerve Conduction Studies and Electromyography in the Evaluation of Peripheral Nerve Injuries , 1999 .

[17]  J. Albers,et al.  Relation between needle electromyography and nerve conduction studies in patients with carpal tunnel syndrome. , 1995, Archives of physical medicine and rehabilitation.

[18]  A. C. Petersen [Brachial neuritis]. , 1988, Ugeskrift for laeger.

[19]  F. Mastaglia Musculocutaneous neuropathy after strenuous physical activity , 1986, The Medical journal of Australia.

[20]  J. Nunley,et al.  Compression of the musculocutaneous nerve at the elbow. , 1982, The Journal of bone and joint surgery. American volume.