Etiological study of superficial radial nerve neuropathy: series of 34 patients

Abstract

ObjectivesSuperficial radial nerve (SRN) neuropathy is a rare focal neuropathy leading to pain and paresthesia of the dorsolateral aspect of the hand. Reported causes include trauma, extrinsic compression, or it may be idiopathic. We describe the clinical and electrodiagnostic (EDX) features of 34 patients with SRN neuropathy of varied etiology.MethodsThis is a retrospective study of patients with upper limb neuropathy referred for EDX studies who were found to have SRN neuropathy based on clinical and EDX findings. Twelve patients also had ultrasound (US) evaluations.ResultsDecreased pinprick sensation was noted in the distribution of the SRN in 31 (91%) patients, and a positive Tinel’s sign was observed in 9 (26%). Sensory nerve action potentials (SNAPs) were not recordable in 11 (32%) patients. Of the patients who had a recordable SNAP, the latency was delayed, and the amplitude was decreased in all cases. Of the 12 patients who underwent US studies, 6 (50%) had an increased cross-sectional area of the SRN at or immediately proximal to the site of injury/compression. A cyst was located adjacent to the SRN in 2 patients. The most common cause of SRN neuropathy was trauma in 19 (56%) patients, of which 15 were iatrogenic. A compressive etiology was identified in 6 patients (18%). No specific etiology was detected in 10 patients (29%).ConclusionThis study is aimed at raising the awareness among surgeons about the clinical features and varied causes of SRN neuropathy; such knowledge may potentially lessen iatrogenic causes of injury.

Superficial thrombophlebitis in the forearm leading to entrapment of the radial nerve branch: a first case report and literature review

“…The similar pain can be from the overlap of the lateral antebrachial cutaneous nerve which occurs in 75% of people [ 14 ]. Superficial position of the superficial branch of the radial nerve, which is easy to be injured, including trauma, external compression (wrist watch, plaster model), internal compression (ganglion cyst, lipoma, abscess, bone spur) and iatrogenic injury [ 15 ]. The combination of MR or ultrasound imaging and electrical diagnosis research can realize more accurate initial diagnosis and timely treatment [ 16 ].…”

Upper Extremity Ballistic Nerve Injury

“…There has been an increase in the literature regarding ultrasound of ballistic nerve injury with multiple recent publications 47-51 . In the acute setting of injury, inflammation and edema can lead to sonographic changes, such as increased nerve cross-sectional areas, enlargement of the fascicles, and decreased echogenicity 48,50 .…”

“…In the acute setting of injury, inflammation and edema can lead to sonographic changes, such as increased nerve cross-sectional areas, enlargement of the fascicles, and decreased echogenicity 48,50 . Ultrasound can evaluate nerve discontinuity to help distinguish between neurotmesis vs. axonotmesis and identify neuroma in continuity without fascicular continuity or sites of compression such as from scar formation 47-49,52 . For traumatic nerve deficits, ultrasound findings helped inform the diagnosis and time frame for nerve exploration 49 .…”

Causes of Dorsal Cutaneous Branch of the Ulnar Nerve Neuropathy Among Patients Undergoing Electrodiagnostic Studies: A Series of 14 Patients

“…In 1922 Stopford reported the first two cases of neuropathy of the DCBUN from a "wristlet watch" [3]. The pathogenesis and clinical presentation are similar to Wartenberg's syndrome characterized by a focal neuropathy of the superficial radial nerve that leads to pain and paresthesia of the dorsoradial aspect of the hand [3][4][5].…”