Median Neuropathy—Pronator Teres Syndrome and Anterior Interosseous Neuropathy

2018 ◽  
Author(s):  
Russell A. Payne ◽  
Kimberly S. Harbaugh
Keyword(s):  
Nerve Palsy ◽  
Cervical Radiculopathy ◽  
Distal Phalanx ◽  
Neuralgic Amyotrophy ◽  
Pronator Teres ◽  
Pronator Syndrome ◽  
Anterior Interosseous Nerve ◽  
Tunnel Syndrome ◽  
Volar Forearm ◽  
Forearm Pain

Pronator teres syndrome results from median nerve compression or irritation at the elbow region. Patients typically note volar forearm pain and median sensory disturbance that includes the palm. Electrodiagnostic studies are helpful in excluding carpal tunnel syndrome and cervical radiculopathy, and findings may be normal in pronator syndrome. A lack of sensory findings and motor loss in flexion of the distal phalanx of the radial three digits suggests anterior interosseous nerve palsy, typically due to neuralgic amyotrophy. When conservative treatment fails, surgical release of all potential points of compression is successful in alleviating symptoms in the majority of patients with pronator syndrome.

Transient Proximal Median Nerve Entrapment in a Tetraplegic Hand Cyclist Following a 24-Hour Endurance Race

2021 ◽  
Author(s):  
Søren Bruno Elmgreen
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Unusual Case ◽  
Endurance Athlete ◽  
Nerve Entrapment ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Tunnel Syndrome ◽  
Anterior Interosseous Nerve Syndrome

ABSTRACT Median nerve entrapment is a frequent disorder encountered by all clinicians at some point of their career. Affecting the distal median nerve, entrapment occurs most frequently at the level of the wrist resulting in a carpal tunnel syndrome. Median nerve entrapment may also occur proximally giving rise to the much less frequent pronator teres syndrome and even less frequent anterior interosseous nerve syndrome, which owing to the paucity of cases may prove challenging to diagnose. An unusual case of anterior interosseous syndrome precipitated by extraordinary exertion in a tetraplegic endurance athlete is presented with ancillary dynamometric, electrodiagnostic, ultrasonographic, and biochemical findings.

Case 16

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Phrenic Nerve ◽  
Cervical Radiculopathy ◽  
Axillary Nerve ◽  
Brachial Plexopathy ◽  
Long Thoracic Nerve ◽  
Motor Branch ◽  
Neuralgic Amyotrophy ◽  
Needle Electromyography ◽  
Brachial Neuritis ◽  
Anterior Interosseous Nerve

Neuralgic amyotrophy is a relatively uncommon disorder but important to recognize since it may be confused with brachial plexopathy, cervical radiculopathy and entrapment/compressive mononeuropathies of the upper extremity. Neuralgic amyotrophy is also known as acute brachial neuritis, acute brachial plexitis, and Parsonage-Turner syndrome. This case highlights the variable clinical and electrodiagnostic findings encountered in patients with neuralgic amyotrophy, with special attention to the most common mononeuropathies affected in this disorder. This include the long thoracic nerve, axillary nerve, phrenic nerve and anterior interosseous nerve. The peculiar needle electromyography findings associated with neuralgic amyotrophy, including selective motor branch involvement, are also discussed.

Neuralgic amyotrophy manifesting as anterior interosseous nerve palsy

1980 ◽  
Vol 3 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Glenn D. Rennels ◽  
Jos� Ochoa
Keyword(s):  
Nerve Palsy ◽  
Neuralgic Amyotrophy ◽  
Anterior Interosseous Nerve

scholarly journals A rare and severe case of pronator teres syndrome

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Francisco Serra E Moura ◽  
Anil Agarwal
Keyword(s):  
Median Nerve ◽  
Severe Case ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Median Nerve Neuropathy ◽  
Tunnel Syndrome ◽  
Proximal Forearm ◽  
Anterior Interosseous Nerve Syndrome ◽  
Timely Referral ◽  
Pure Motor

Abstract We present the case of a patient with severe symptoms of proximal forearm median nerve neuropathy. Over the course of 5 years his condition progressed to encompass rare features of combined pronator teres syndrome (PTS) and anterior interosseous nerve syndrome (AINS). The aetiology was found to be pronator teres compression and was managed successfully by surgical decompression. Proximal forearm median nerve compression should be considered as a continuum with two classic endpoints. At one end of the spectrum pure PTS presents with solely or mainly sensory symptoms, whereas at the other end AINS presents with pure motor symptoms. Hence, all possible anatomical sites of compression must be surgically explored in all cases of PTS or AINS, regardless of symptomatology. Timely referral to an experienced specialist is encouraged to ensure good outcomes, whenever a primary care practitioner encounters an atypical carpal tunnel syndrome-like presentation.

scholarly journals Two muscular variations in the elbow associated with the anterior interosseous nerve

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Bartłomiej Szewczyk ◽  
Nicol Zielinska ◽  
Dariusz Grzelecki ◽  
Michał Polguj
Keyword(s):  
Biceps Brachii ◽  
Clinical Importance ◽  
Ulnar Artery ◽  
Flexor Pollicis Longus ◽  
Main Band ◽  
Anatomical Dissection ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Male Cadaver ◽  
The Right

AbstractThe coexistence of different muscular-neurovascular variations is of significant clinical importance. A male cadaver, 76 years old at death, was subjected to routine anatomical dissection; the procedure was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The right forearm and hand were dissected using standard techniques according to a strictly specified protocol. The presence accessory head of the flexor pollicis longus may potentially compress the anterior interosseous nerve. The present case report describes a rare variant of the ulnar head of the pronator teres, characterized by two independent bands (i.e., two proximal attachments). The main band originates from the coronoid process and the second originates from the tendon of the biceps brachii. This type of attachment could potentially affect the compression of the ulnar artery running between the two bands. Additionally, the accessory head of the flexor pollicis longus was observed, which started on the medial epicondyle; its coexistence with a high division median nerve creates a potential pressure site on the anterior interesosseous nerve.

scholarly journals Neuralgic amyotrophy: an underrecognized entity

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110065
Author(s):  
Tae Uk Kim ◽  
Min Cheol Chang
Keyword(s):  
Clinical Practice ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Cervical Radiculopathy ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Magnetic Resonance Neurography ◽  
Essential Information ◽  
Neuralgic Amyotrophy

Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide an overview of essential information about NA, including the etiology, clinical manifestations, diagnostic investigations, differential diagnosis, treatment, and prognosis. The causes of NA are multifactorial and include immunological, mechanical, or genetic factors. Typical clinical findings are a sudden onset of pain in the shoulder region, followed by patchy flaccid paralysis of muscles in the shoulder and/or arm. A diagnosis of NA is based on a patient’s clinical history and physical examination. Gadolinium-enhanced magnetic resonance imaging and high-resolution magnetic resonance neurography are useful for confirming the diagnosis and choosing the appropriate treatment. However, before a diagnosis of NA is confirmed, other disorders with similar symptoms, such as cervical radiculopathy or rotator cuff tear, need to be ruled out. The prognosis of NA depends on the degree of axonal damage. In conclusion, many patients with motor weakness and pain are encountered in clinical practice, and some of these patients will exhibit NA. It is important that clinicians understand the key features of this disorder to avoid misdiagnosis.

scholarly journals Relationship Between the Idiopathic Anterior Interosseous Nerve Palsy and “Hourglass-like Fascicular Constriction”

2015 ◽  
Vol 40 (9) ◽  
pp. e40-e41
Author(s):  
Toru Sunagawa ◽  
Yuko Nakashima ◽  
Rikuo Shinomiya ◽  
Mitsuo Ochi
Keyword(s):  
Nerve Palsy ◽  
Anterior Interosseous Nerve
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