Compressive Radial Neuropathy Research Articles

Surgical Treatment of Compressive Radial Neuropathy Presenting with Motor Weakness and Pain: A Case Report

Surgical Treatment of Compressive Radial Neuropathy Presenting with Motor Weakness and Pain: A Case Report

P51-T A new approach to the radial nerve conduction block determination in the upper arm

Background There are technical limitations in the radial nerve studies in the upper arm using surface electrodes. One of the limitations is that stimulation at the axilla and Erb‘s point stimulates the entire brachial plexus along with the radial nerve. Material and methods Twenty-one healthy volunteers, 55 patients with compressive neuropathies of the radial nerve in the spiral groove and 22 patients with complete radial nerve injuries were studied. Control group (65 radial nerves) consisted of healthy subjects and patients with the undamaged side. Stimulation was carried out at: (1) the distal part of lateral brachium (distal point); (2) Erb’s point (proximal point); (3) the middle part of medial brachium – median and ulnar nerves (additional point). CMAP area recorded from the extensor digitorum was analyzed. Conduction block (CB) in percentage was calculated using the formula: ((distal CMAP + additional CMAP) − (proximal CMAP)) × 100/(distal CMAP + additional CMAP). Results In control group and patients with complete nerve injury CB was not registered (4.2 ± 9.8% and −1.7 ± 11.7% respectively), whereas in patients with compressive radial nerve neuropathy CB was 61.2 ± 11.2% (P Conclusion Median and ulnar nerves stimulation in the middle part of medial brachium is recommended as an additional brachium diagnostic point for radial nerve CB determination.

Reversible reddish skin color change in a patient with compressive radial neuropathy

BackgroundThe motor and sensory symptoms caused by compressive radial neuropathy are well-known, but the involvement of the autonomic nervous system or the dermatologic symptoms are less well known. We report an unusual case of compressive radial neuropathy with reversible reddish skin color change.Case presentationA 42-year-old man was referred for left wrist drop, finger drop and a tingling sensation over the lateral dorsum of the left hand. Based on clinical information, neurologic examinations and electrophysiologic studies, he was diagnosed with compressive radial neuropathy. In addition, a reddish skin color change was observed at the area of radial sensory distribution. After two weeks of observation without specific treatment, the skin color had recovered along with a marked improvement in weakness and aberrant sensation.ConclusionsCompressive radial neuropathy with a reversible reddish skin color change is unusual and is considered to be due to vasomotor dysfunction of the radial autonomic nerve. Compressive radial neuropathy is presented with not only motor and sensory symptoms but also autonomic symptoms; therefore, careful examination and inspection are needed at diagnosis.

The usefulness of proximal radial motor conduction in acute compressive radial neuropathy (P3.183)

The usefulness of proximal radial motor conduction in acute compressive radial neuropathy (P3.183)

The usefulness of proximal radial motor conduction in acute compressive radial neuropathy.

Background and PurposeThe objective of this study was to determine diagnostic and prognostic values of proximal radial motor conduction in acute compressive radial neuropathy.MethodsThirty-nine consecutive cases of acute compressive radial neuropathy with radial conduction studies-including stimulation at Erb's point-performed within 14 days from clinical onset were reviewed. The radial conduction data of 39 control subjects were used as reference data.ResultsThirty-one men and eight women (age, 45.2±12.7 years, mean±SD) were enrolled. All 33 patients in whom clinical follow-up data were available experienced complete recovery, with a recovery time of 46.8±34.3 days. Partial conduction block was found frequently (17 patients) on radial conduction studies. The decrease in the compound muscle action potential area between the arm and Erb's point was an independent predictor for recovery time.ConclusionsProximal radial motor conduction appears to be a useful method for the early detection and prediction of prognosis of acute compressive radial neuropathy.

Clinical features of wrist drop caused by compressive radial neuropathy and its anatomical considerations.

ObjectivePosture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy.MethodsRetrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records.ResultsSubjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients.ConclusionWrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.

Compressive radial neuropathy developed under a fibrotic band associated with rhabdomyolysis and successfully treated with surgery.

A 34-year-old male patient visited the emergency room with complaint of right wrist drop and foot drop. The day before, he was intoxicated and fell asleep in a room containing barbeque briquettes; After waking up, he noticed that his right wrist and foot were dropped. Upon physical examination, his right wrist extensor, thumb extensor, ankle dorsiflexor, and big toe extensor showed Medical Research Council (MRC) grade 1 power. The initial laboratory tests suggested rhabdomyolysis induced by unrelieved pressure on the right side during sleep. Right foot drop was improved after conservative care and elevated muscle enzyme became normalized with hydration therapy with no resultant acute renal failure. However, the wrist drop did not show improvement and a hard mass was palpated on the follow-up physical examination. Ultrasonography and magnetic resonance imaging studies were conducted and an abnormal mass in the lateral head of the tricep was detected. Axonopathy was suggested by the electrodiagnostic examination. A surgical decompression was done and a fibrotic cord lesion compressing the radial nerve was detected. After adhesiolysis, his wrist extensor power improved to MRC grade 4. Herein, we describe a compressive radial neuropathy associated with rhabdomyolysis successfully treated with surgery and provide a brief review of the related literature.

9. Diagnostic and prognostic usefulness of proximal radial motor nerve conduction study in acute compressive radial neuropathy

9. Diagnostic and prognostic usefulness of proximal radial motor nerve conduction study in acute compressive radial neuropathy

72. Unusual focal compressive radial neuropathy in a patient with Guillain-Barré syndrome: A case report

72. Unusual focal compressive radial neuropathy in a patient with Guillain-Barré syndrome: A case report

Prognosis of acute compressive radial neuropathy

Small published case series suggest that compressive radial neuropathy is often a self-limited phenomenon with a favorable prognosis. Due to paucity of data, we sought to clearly define prognosis. To define clinical and electrodiagnostic features in this condition, we retrospectively reviewed consecutive cases of compressive radial neuropathy confirmed using electrodiagnostic studies at a large tertiary center over a 10-year period. A total of 51 patients (26 men, 25 women, mean age 46 years ± 15; range, 19-83 years) with compressive radial neuropathy were identified and reviewed. All patients in whom clinical follow-up was available (23 [45%] of the 51 patients identified) experienced complete recovery. Mean duration from onset to resolution of symptoms was 3.4 months. Our results support a good prognosis in essentially all patients with acute compressive radial neuropathies. This report provides valuable information to assist in counseling patients who may present with profound clinical deficits.

Diagnostic and Prognostic Usefulness of Proximal Radial Motor Nerve Conduction Study in Acute Compressive Radial Neuropathy

Diagnostic and Prognostic Usefulness of Proximal Radial Motor Nerve Conduction Study in Acute Compressive Radial Neuropathy

Compressive radial neuropathy induced by ‘hooking’ manoeuvre in a tetraplegic person

Case report. To describe a case of radial nerve compression neuropathy caused by a common wheelchair technique (hooking manoeuvre) used by a tetraplegic person to maintain truncal stability on a wheelchair. Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia. A 45-year-old man with American Spinal Injury Association Impairment Scale A C6 for the last 32 years developed progressive weakness of the right upper limb that was associated with pain in the shoulder and arm. Serial physical examinations demonstrated motor and sensory deterioration. Magnetic resonance imaging of the spinal cord showed no evidence of syringomyelia. Electrodiagnostic study showed motor and sensory neuropathy of the right radial nerve in the axillary region. The act of hooking the arm behind the wheelchair push handle causes trauma leading to radial nerve compression neuropathy. Because this technique is used frequently by wheelchair users, future studies should examine the prevalence of radial neuropathy in this population and develop alternative methods to maintain balance on the wheelchair.