Severe and persistent nerve palsy after ultrasound-guided continuous interscalene brachial plexus block in a teenager undergoing shoulder surgery: a case report

BACKGROUND: Although neurologic sequela is a recognized complication after interscalene brachial plexus block (ISB), there is a paucity of information on how severe and persistent neuropathy occurs and develops. CASE PRESENTATION: A healthy high school soccer goalkeeper was scheduled for an arthroscopic Bankart repair. After continuous ISB for 2 days, sensation in the C5 and C6 areas and motor function did not return. With symptomatic drug treatment for neuropathic pain and rigorous rehabilitation, recovery of sensory loss and muscle weakness were gradually observed around 1 to 2 months after surgery. He returned to sport 1 year after surgery. CONCLUSION: This report is the first detailed description of a case who incurred severe and persistent nerve injury after continuous ISB yet recovered nearly fully to return to being an athlete. The present case should also underscore the importance of close observation after surgery in cases where a patient receives continuous ISB.