Traumatic musculocutaneous neuropathy: a case report

Isolated injury of the musculocutaneous nerve is a rare disorder. Reported cases are claimed to present with loss of biceps and brachialis power without a disturbing pain. The injury generally occurs after strenuous exercise and could be demonstrated by electrophysiological examination. We report a case of musculocutaneous nerve injury which occurred after a vigorous push and which presented with unusual symptoms and findings. The patient complained of episodic severe pain attacks which started from the axilla and radiated over the musculocutaneous nerve distribution including the lateral antebrachial cutaneous nerve area. He did not respond to 3 months of conservative treatment including multiple corticosteroid injections and finally required surgical release. Surgical epineurotomy resulted in immediate relief. This is the first reported case of acute musculocutaneous nerve injury presenting with unusual symptoms and findings. The operative release procedure performed was also not required in any of the other reported cases. An excellent result was obtained with epineurotomy.