Department of Neurology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
J Clin Neurophysiol. 2023 May 1;40(4):286-292. doi: 10.1097/WNP.0000000000000904. Epub 2021 Oct 22.
Winged scapula (WS) is a functionally disabling problem and it occurs because of neurogenic causes frequently. The authors aimed to assess WS patients by physical and electrodiagnostic examinations as well as some further investigations and define the common causes of WS.
The authors reviewed clinical and neurophysiological findings of 52 patients who were referred for electrodiagnostic examination because of WS in the period of 20 years.
The mean age was 39 (range, 11-73) years and 32 were male patients. Right side was involved in 60% of patients (n = 31). According to electrodiagnostic examinations, 44 patients (85%) had neurogenic causes; 29 spinal accessory nerve palsy (17 occurred after surgical procedure), nine long thoracic nerve palsy (four occurred after strenuous activity), two dorsal scapular nerve (both neuralgic amyotrophy), one long thoracic nerve and spinal accessory nerve (relevant with strenuous trauma), one spinal accessory nerve and dorsal scapular nerve palsies (after surgical procedure and radiotherapy), one C5-7 radiculopathy (avulsion), and one brachial plexopathy (obstetric trauma). Five patients (10%) had muscle-related findings (four facio-scapulo-humeral dystrophy and one Duchenne muscular dystrophia) and three patients (5%) had normal findings (bone-joint related).
This study presents a relatively large series of patients with WS because of several causes from a referral tertiary EMG laboratory. The authors found that spinal accessory nerve palsy after neck surgery is the most common cause and long thoracic nerve palsy is the second common cause of unilateral WS. Electrodiagnostic examinations should be performed in WS patients to establish exact diagnosis and reveal some coexistence of WS causes.
翼状肩胛（WS）是一种功能障碍性问题，通常由神经原因引起。作者旨在通过物理和电诊断检查以及一些进一步的调查来评估 WS 患者，并确定 WS 的常见原因。
作者回顾了 20 年来因 WS 接受电诊断检查的 52 例患者的临床和神经生理学发现。
平均年龄为 39 岁（范围 11-73 岁），32 例为男性患者。右侧受累占 60%（n = 31）。根据电诊断检查，44 例（85%）患者存在神经源性病因；29 例为副神经麻痹（17 例发生于手术后），9 例为胸长神经麻痹（4 例发生于剧烈活动后），2 例为肩胛背神经（均为神经痛性肌萎缩），1 例胸长神经和副神经（与剧烈创伤相关），1 例副神经和肩胛背神经麻痹（手术后和放疗后），1 例 C5-7 神经根病（撕脱），1 例臂丛神经病（产科创伤）。5 例（10%）患者存在肌肉相关表现（4 例面肩肱型肌营养不良和 1 例杜氏肌营养不良），3 例（5%）患者表现正常（与骨-关节相关）。
本研究报告了来自一家转诊三级肌电图实验室的因多种原因导致 WS 的相对较大系列患者。作者发现，颈部手术后的副神经麻痹是最常见的原因，单侧 WS 的第二大常见原因是胸长神经麻痹。应在 WS 患者中进行电诊断检查，以确立明确的诊断并揭示 WS 病因的一些共存。
