Adair W A, Schwartz G
Arch Phys Med Rehabil. 1985 Oct;66(10):713-6.
This report describes a rare case of acquired axillary neuropathy in a 17-year-old C-5 quadriplegic man who developed right axillary neuropathy after sleeping for six hours in a far-right lateral decubitus position. Two days after the onset of shoulder weakness, his shoulder abduction strength was found to have decreased 1 1/2 grades from measurements made 2 weeks before. Electrodiagnostic studies demonstrated no voluntary activity of the deltoid and no deltoid evoked response on stimulation at Erb's point, while shoulder nerve conduction latencies to other C-5 and posterior cord innervated muscles were within normal limits, suggesting a diagnosis of axillary nerve compression in the region of the quadrilateral space. Six and one-half months later, after strengthening exercises and shoulder joint support to prevent subluxation, the patient recovered deltoid strength and upper extremity function beyond that seen at the onset of the axillary neuropathy. This case emphasizes the importance of proper body positioning of spinal cord injured (SCI) patients to prevent peripheral nerve compression and further disability.
本报告描述了一例罕见的获得性腋神经病变病例，患者为一名17岁的C5级四肢瘫痪男性，在向右侧卧位睡眠6小时后出现右侧腋神经病变。肩部无力发作两天后，发现其肩部外展力量较两周前测量时下降了1.5级。电诊断研究显示三角肌无自主活动，在Erb点刺激时无三角肌诱发反应，而肩部神经传导至其他C5和后索支配肌肉的潜伏期在正常范围内，提示四边孔区域腋神经受压。六个半月后，经过强化锻炼和肩关节支撑以防止半脱位，患者三角肌力量和上肢功能恢复，超过了腋神经病变发作时的水平。该病例强调了脊髓损伤（SCI）患者正确体位对于预防周围神经受压和进一步残疾的重要性。
