Ebru BÖLÜK, Aysel ÇOBAN TAŞKIN
Neurological Sciences and Neurophysiology - 2026;43(3):134-138
Context: Proximal neuropathies of the shoulder and upper limb represent a heterogeneous group of peripheral nerve injuries that may occur after trauma or as iatrogenic complications and can mimic cervical radiculopathy or brachial plexopathy. Aims: To describe the etiologic spectrum and electrophysiologic characteristics of traumatic and iatrogenic proximal neuropathies encountered in a tertiary referral electromyography (EMG) laboratory. Settings and Design: Retrospective descriptive observational study in a tertiary electrodiagnostic laboratory. Subjects and Methods: Patients referred between October 2021 and January 2024 with suspected proximal shoulder or upper limb involvement were retrospectively reviewed. Inclusion required an electrophysiologically confirmed non-plexus proximal peripheral nerve injury involving at least one nerve. Brachial plexus lesions and entrapment neuropathies were excluded. All patients underwent standardized nerve conduction studies and needle EMG. Statistical Analysis Used: Continuous variables were analyzed using the Mann-Whitney U test, and categorical variables were compared using Fisher's exact test. Results: Twenty-seven patients (eight females, 19 males; mean age 49.4 +/- 21.3 years) were included. Traumatic etiology was identified in 20 patients (74.1%), and 7 (25.9%) had iatrogenic nerve injuries. The axillary nerve was most frequently affected (37.0%), followed by the long thoracic and suprascapular nerves (18.5% each). Multiple nerve involvement occurred in four patients. No statistically significant differences were detected between etiologic groups. Conclusions: In tertiary practice, proximal neuropathies of the shoulder and upper limb often present with subtle clinical findings. Targeted electrodiagnostic evaluation provides objective confirmation and supports localization, particularly when pain or immobilization limits clinical assessment.
