Pronator Syndrome and other Nerve Compressions that Mimic Carpal Tunnel Syndrome a Case Report and Literature Review

Abstract

The resolution of small to intermediate-sized anomalies affecting the craniofacial region can pose a formidable problem Proximal neuropathy of the median nerve (MN) is a relatively rare condition, accounting for approximately 1% of all compressive neuropathies affecting the upper limb. The existing body of literature documents two distinct clinical presentations, which are based upon the location of entrapment. These presentations are commonly referred to as pronator teres (PT) syndrome and anterior interosseous nerve (AIN) syndrome. Pronator teres syndrome, also known as median nerve compression in the upper forearm, manifests as a constellation of clinical manifestations and indications. Carpal tunnel syndrome is a dynamic condition that is commonly characterized by the compression of the median nerve within the carpal tunnel. Although relatively uncommon when compared to carpal tunnel syndrome, pronator syndrome and anterior interosseous nerve syndrome are conditions involving compression of the proximal median nerve. These conditions may be considered as potential diagnoses when a patient with carpal tunnel syndrome does not show improvement following conservative or surgical treatment. The process of differential diagnosis primarily relies on the evaluation of symptoms, the analysis of paresthesia patterns, and the identification of distinct patterns of muscle weakness. Initial management of all patients should primarily involve nonsurgical treatment modalities. However, it has been demonstrated through empirical evidence that surgical intervention may produce favorable outcomes. Many surgical methodologies have been established, with the majority of outcome data derived from retrospective case series. A full comprehension of the anatomical structure of the median nerve, possible points of compression, and distinctive clinical manifestations of carpal tunnel syndrome (CTS) is imperative for physicians in order to correctly identify and successfully manage their patients.