Phrenic nerve injury usually accompanies signs and symptoms of:

• A. Klumpke palsy
• B. Torticollis
• C. Facial nerve palsy
• D. Erb-Duchenne palsy

Answer: (D)

Injury to the phrenic nerve most often comes with problems from the upper part of the brachial plexus, where the C5–C6 roots lie. Erb-Duchenne palsy is an injury to that upper trunk, so traction or damage can involve the phrenic nerve as well. Since the phrenic nerve controls the diaphragm, this can lead to diaphragmatic weakness or paralysis alongside the arm weakness and characteristic posture seen with Erb-Duchenne palsy.

Klumpke palsy involves the lower trunk (C8–T1) and is less likely to involve the phrenic nerve. Torticollis is a neck muscle/position issue, not a nerve injury pattern, and facial nerve palsy involves the facial nerve (cranial nerve VII), not the brachial plexus. So the association with phrenic nerve injury is best explained by Erb-Duchenne palsy.