Acute brachial radiculitis / by J.W. Aldren Turner.

  • Turner, J. W. Aldren (J. William Aldren), 1864-1945.
Date:
[1944]
Catalogue details

Licence: Public Domain Mark

Credit: Acute brachial radiculitis / by J.W. Aldren Turner. Source: Wellcome Collection.

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    present, but over a smaller area than previously. The left serratu magnus remained paralysed. Anatomical Distribution of the Lesions in the Series (a) Cases Confined to a Single Peripheral Nerve.—The peri pheral nerve most commonly involved was the long thoracii nerve, with resultant winging of the scapula and difficulty it raising the affected arm above a right-angle. Isolated palsie: of this nerve have been recognized for many years, anc Richardsorr, in 1942, drew attention to their comparativi frequency. The reason for including the isolated non traumatic cases in this series is because in 4 instance; paralysis of the serratus magnus has occurred on one sid< with involvement of other muscles in the other arm, whih in 6 cases other muscles on the same side have been involved together with the serratus magnus. There have also been 1] examples of isolated serratus magnus palsy. It has been fount that if the paralysis of this muscle first occurs while the patien is in bed with some other complaint he may not notice tin muscle weakness himself; it is usually first noted when h< tries to stretch up to take something off a high shelf. Th<; suprascapular nerve has been involved alone in two cases witl paralysis of supra- and infra-spinatus and weakness of externa rotation of the arm. It was noticeable in one case, seen som< months after the onset of the disability, that the two muscle were involved in very different degrees, the infraspinatus bein; considerably weaker and more wasted than the supraspinatus There were two examples of isolated circumflex palsies wit! paralysis of the deltoid and sensory impairment over the nerv distribution. In one case the musculo-cutaneous was the onl nerve involved, with loss of power of the biceps and sensor impairment in the distribution of the lateral cutaneous nerv of the forearm. The disability was relatively slight, as goo flexion of the elbow was carried out by the supinator longui the main weakness being in supination. (b) Cases of Root Involvement.—There were 5 examples < involvement of C.5 and 6 roots, of which the case describe above is one. In these cases the muscles affected were th spinati, deltoid, biceps, supinator longus, and sometimes tl clavicular head of the pectoralis major ; and there was impai ment or absence of the biceps and supinator jerks, with sensoi impairment on the outer side of the arm and forearm. In or case the C.7 root was affected in addition to C.5 and 6, ; shown by weakness of the triceps and extensors of the wri and fingers as well as of the muscles just mentioned. (c) Muscle Involvement Not Explicable in Above Groups.- In a number the muscle weakness was not explicable on tl basis of involvement of a single peripheral nerve or in terr of root distribution, as in the following cases : spinati ai serratus magnus on one side (2 cases); deltoid and spin* (7 cases); deltoid and biceps (1 case); spinati and serrat mqgnus on both sides (2 cases); sterno-mastoid, trapezius, ~d< toid, spinati, and serratus magnus (1 case); while in anoth case there was widespread bilateral involvement affecting t spinati, deltoid, and triceps on one side, with the spinati, bicep