Cervical plexus lesions in clinical practice

Czech version

Authors: Z. Kadaňka Jr.; J. Bednařík
Authors‘ workplace: Neurologická klinika LF MU a FN Brno
Published in: Cesk Slov Neurol N 2019; 82(6): 616-620
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2019616

Overview

Cervical plexus lesions are relatively rare and may be overlooked by clinical neurologists. Several new clinical syndromes centered upon this region have been published in recent years. Herein we present an overview of possible etiologies of cervical plexus lesions, their diagnosis and treatment. Relatively the most common condition is occipital neuralgia, which is largely considered idiopathic. We report considerable auricular neuralgia and red ear syndrome, and neuralgias of Jacobson’s and Arnold’s nerves (branches of the glossopharyngeal and vagus nerves). We deal also with phrenic nerve lesion, which is usually unilateral and asymptomatic. Nevertheless, bilateral diaphragmatic palsy may result in disabling dyspnea requiring mechanical ventilation.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

cervical plexus – occipital neuralgia – great auricular neuralgia – red ear syndrome – phrenic nerve palsy

Sources

1. Kadaňka Z Jr, Hanák J, Gál B. Malignant peripheral nerve sheath tumour of cervical plexus – a case report. Cesk Slov Neurol N 2013; 76/ 109(6): 751–755.

2. Choi I, Jeon SR. Neuralgias of the head: occipital neuralgia. J Korean Med Sci 2016; 31(4): 479–488. doi: 10.3346/ jkms.2016.31.4.479.

3. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders. 3rd ed (beta version). Cephalalgia 2013; 33(9): 629–808. doi: 10.1177/ 0333102413485658.

4. Belvís R, Guerrero ÁL. Benito’s neuralgia: the first description of the occipital neuralgia was made for Spanish doctors at the beginning of the nineteenth century. Neurol Sci 2019. 40(11): 2425–2429 doi: 10.1007/ s10072-019-03734-5.

5. Vanelderen P, Lataster A, Levy R et al. 8. occipital neuralgia. Pain Pract 2010; 10(2): 137–144. doi: 10.1111/ j.1533-2500.2009.00355.x.

6. Ha S, Choi J, Son B. Occipital neuralgia from C2 cavernous malformation. Asian J Neurosurg 2018; 13(2): 442–445. doi: 10.4103/ 1793-5482.181131.

7. Bruti G, Mostardini C, Pierallini A et al. Neurovascular headache and occipital neuralgia secondary to bleeding of bulbocervical cavernoma. Cephalalgia 2007; 27(9): 1074–1079. doi: 10.1111/ j.1468-2982.2007.01363.x.

8. White JB, Atkinson PP, Cloft HJ et al. Vascular compression as a potential cause of occipital neuralgia: a case report. Cephalalgia 2008; 28(1): 78–82. doi: 10.1111/ j.1468-2982.2007.01427.x.

9. Garza I. Craniocervical junction schwannoma mimicking occipital neuralgia. Headache 2007; 47(8): 1204–1055. doi: 10.1111/ j.1526-4610.2007.00887.x.

10. Boes CJ. C2 myelitis presenting with neuralgiform occipital pain. Neurology 2005; 64(6). doi: 10.1212/ 01.WNL.0000154470.19225.49. [online]. Available from URL: https:/ / n.neurology.org/ content/ 64/ 6/ 1093.long.

11. Santi LD, Monti L, Menci E et al. Clinical-radiologic heterogeneity of occipital neuralgiform pain as multiple sclerosis relapse. Headache 2009; 49(2): 304–307. doi: 10.1111/ j.1526-4610.2008.01209.x.

12. Tancredi A, Caputi F. Greater occipital neuralgia and arthrosis of C1–2 lateral joint. Eur J Neurol 2004; 11(8): 573–574. doi: 10.1111/ j.1468-1331.2004.00875.x.

13. Piovesan EJ, Werneck LC, Kowacs PA et al. [Greater occipital neuralgia associated with occipital osteolytic lesion. Case report. Arq Neuropsiquiatr 1999; 57(1): 114–119. doi: 10.1590/ s0004-282x1999000100023.

14. Finiels PJ, Batifol D. The treatment of occipital neuralgia: review of 111 cases. Neurochirurgie 2016; 62(5): 233–240. doi: 10.1016/ j.neuchi.2016.04.004.

15. Greher M, Moriggl B, Curatolo M et al. Sonographic visualization and ultrasound-guided blockade of the greater occipital nerve: a comparison of two selective techniques confirmed by anatomical dissection. Br J Anaesth 2010; 104(5): 637–642. doi: 10.1093/ bja/ aeq052.

16. D’Souza RS, Warner NS. Phenol nerve block. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2019. [onlne]. Available from URL: http:/ / www.ncbi.nlm.nih.gov/ books/ NBK525978/ .

17. Park SW, Choi JY, Jung KJ. Management of great auricular neuralgia confirmed by electrophysiologic examination: a case report. J Oral Facial Pain Headache 2018; 32(32): e53–e56. doi: 10.11607/ ofph.2144.

18. Jeon Y, Kim S. Treatment of great auricular neuralgia with real-time ultrasound-guided great auricular nerve block: a case report and review of the literature. Medicine (Baltimore) 2017; 96(12): e6325. doi: 10.1097/ MD.0000000000006325.

19. Barbour JR, Iorio ML, Halpern DE. Surgical decompression of the great auricular nerve: a therapeutic option for neurapraxia following rhytidectomy. Plast Reconstr Surg 2014; 133(2): 255–260. doi: 10.1097/ 01.prs.0000436861.85892.a1.

20. Lance JW. The red ear syndrome. Neurology 1996; 47(3): 617–620. doi: 10.1212/ wnl.47.3.617.

21. Raieli V, D’Amelio M, Brighina F. The mystery of “red ear syndrome”: sign or syndrome. Headache 2019; 59(4): 624–625. doi: 10.1111/ head.13524.

22. Raieli V, Monastero R, Santangelo G et al. Red ear syndrome and migraine: report of eight cases. Headache 2002; 42(2): 147–151. doi: 10.1046/ j.1526-4610.2002.02033.x.

23. de Amorim IL, Kauppila LA, Martins IP. Red ear: syndrome or symptom? Headache 2018; 58(6): 885–891. doi: 10.1111/ head.13333.

24. Lambru G, Miller S, Matharu MS. The red ear syndrome. J Headache Pain 2013; 14: 83. doi: 10.1186/ 1129-2377-14-83.

25. Roberts DS, Yamasaki A, Sedaghat AR et al. Tympanic plexus neurectomy for intractable otalgia. Laryngoscope Investig Otolaryngol 2016; 1(5): 135–139. doi: 10.1002/ lio2.31.

26. Watanabe K, Tubbs RS, Satoh S et al. Isolated deep ear canal pain: possible role of auricular branch of vagus nerve-case illustrations with cadaveric correlation. World Neurosurg 2016; 96: 293–301. doi: 10.1016/ j.wneu.2016.08.102.

27. Ishida R, Palmer JB, Hiiemae KM. Hyoid motion during swallowing: factors affecting forward and upward displacement. Dysphagia 2002; 17(4): 262–272. doi: 10.1007/ s00455-002-0064-5.

28. Faoury M, Frampton S, Allen D et al. Non-selective laryngeal reinnervation in a child with unilateral left vocal fold palsy utilizing laryngeal electromyography. J Surg Case Rep 2019; 2019(2): rjz039. doi: 10.1093/ jscr/ rjz039.

29. Beutner D, Grosheva M. Reconstruction of complex defects of the extracranial facial nerve: technique of “the trifurcation approach”. Eur Arch Otorhinolaryngol 2019; 276(6): 1793–1793. doi: 10.1007/ s00405-019-05418-4.

30. Ehler E, Latta J, Vojtíšek P et al. Oboustranná léze n. phrenicus manifestující se jako ortopnoe – kazuistiky tří případů. Cesk Slov Neurol N 2012; 75/ 108(3): 368–372.

31. Kokatnur L, Rudrappa M. Diaphragmatic palsy. Diseases 2018; 6(1). pii: E16. doi: 10.3390/ diseases6010016.

32. Aslam F, Kolpakchi A, Musher D et al. Unilateral diaphragmatic paralysis in a diabetic patient: a case of trepopnea. J Gen Intern Med 2011; 26(5): 555–558. doi: 10.1007/ s11606-010-1587-3.

33. Djukic M, Larsen J, Lingor P et al. Unilateral phrenic nerve lesion in Lyme neuroborreliosis. BMC Pulm Med 2013; 13: 4. doi: 10.1186/ 1471-2466-13-4

34. Oike M, Naito T, Tsukada M et al. A case of diaphragmatic paralysis complicated by herpes-zoster virus infection. Intern Med 2012; 51(10): 1259–1263. doi: 10.2169/ internalmedicine.51.6935.

35. Helgeson SA, Heckman AJ, Harris DM. First Reported case of respiratory syncytial virus infection causing Guillain-Barré syndrome. Indian J Crit Care Med 2018; 22(4): 309–310. doi: 10.4103/ ijccm.IJCCM_171_17.

36. Chetta A, Rehman AK, Moxham J et al. Chest radiography cannot predict diaphragm function. Respir Med 2005; 99(1): 39–44. doi: 10.1016/ j.rmed.2004.04.016.

37. Nason LK, Walker CM, McNeeley MF et al. Imaging of the diaphragm: anatomy and function. Radiographics 2012; 32(2): E51–E70. doi: 10.1148/ rg.322115127.

38. Gechev A, Kane NM, Koltzenburg M et al. Potential risks of iatrogenic complications of nerve conduction studies (NCS) and electromyography (EMG). Clin Neurophysiol Pract 2016; 1: 62–66. doi: 10.1016/ j.cnp.2016.09.003.

39. Maranhão AA, Carvalho SR, Caetano MR et al. Phrenic nerve conduction studies: normative data and technical aspects. Arq Neuropsiquiatr 2017; 75(12): 869–874. doi: 10.1590/ 0004-282X20170153.

40. Podnar S, Harlander M. Phrenic nerve conduction studies in patients with chronic obstructive pulmonary disease. Muscle Nerve 2013; 47(4): 504–509. doi: 10.1002/ mus.23617.

41. Mandoorah S, Mead T. Phrenic nerve injury. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2019. [online]. Available from URL: http:/ / www.ncbi.nlm.nih.gov/ books/ NBK482227/ .