OBJECTIVE: To investigate the possibility of volume conduction in the superficial radial sensory nerve conduction study in patients with a complete radial nerve injury. METHOD: In patients with a complete radial neuropathy, a superficial radial sensory nerve conduction study was carried out by an antidromic and orthodromic methods. Antidromic technique was carried out by increasing stimulus intensity gradually. Median palmar cutaneous nerve conduction study was also carried out by an antidromic method. RESULTS: When the stimulus intensity was significantly higher than the optimal technique, a median palmar cutaneous nerve action potential was evoked instead of the superficial radial nerve action potential. This is a volume conducting potential which occurrs following a high intensity stimulus. CONCLUSION: Superficial radial sensory conduction study must be carried out by an optimal stimulus intensity and an orthodromic method to eliminate the effect of volume conduction.
Action Potentials ; Humans ; Neural Conduction* ; Radial Nerve ; Radial Neuropathy

PURPOSE: Saturday night palsy is a transient form of nerve palsy that occurs after a prolonged period of direct pressure on the course of radial nerve by one's own or spouse's head. Although commonly encountered, there have been only few studies concerning its convalescence. The purpose of this study is to predict the prognosis of Saturday night palsy based on the causes, time to recovery and degree of recovery. MATERIALS AND METHODS: Retrospective study of 20 patients who were diagnosed compression radial nerve palsy was performed. The average age was 36.7 years old and the mean follow-up period was 19.6 months. We investigated sleeping hours as an indirect measure of nerve compression time, recovery of wrist and finger extension, DASH score on the monthly based follow up. RESULTS: The mean sleeping hours was 5.8 hours and all patients showed full recovery of wrist and fingers extension with the mean duration of symptom for 3.2 months. DASH score was an average 1.53 at the last follow up and we found no statistical significance between the time to recovery and the sleeping hours. CONCLUSION: Complete natural recovery can be expected in compression radial nerve palsy in this study without correlation with sleeping time. Accurate diagnosis is important in order to avoid unnecessary therapeutic intervention and further study should be accomplished for clarifying the related prognostic factors in larger scale of the cases.
Convalescence ; Fingers ; Follow-Up Studies ; Head ; Humans ; Paralysis ; Prognosis ; Radial Nerve ; Radial Neuropathy ; Retrospective Studies ; Wrist

OBJECTIVE: To determine a diagnostic cut-off value for the cross-sectional area (CSA) of the radial nerve using ultrasonography for radial neuropathy located at the spiral groove (SG). METHODS: Seventeen patients with electrodiagnostic evidence of radial neuropathy at the SG and 30 healthy controls underwent ultrasonography of the radial nerve at the SG . The CSAs at the SG were compared in the patient and control groups. The CSA at the SG between the symptomatic and asymptomatic sides (ΔSx–Asx and Sx/Asx, respectively) were analyzed to obtain the optimal cut-off value. The relationship between the electrophysiological severity of radial neuropathy and CSA was also evaluated. RESULTS: Among the variables examined, there were statistically significant differences in the CSA between the patient and control groups, ΔSx–Asx, and Sx/Asx at the SG. In a receiver operating characteristics analysis, the cut-off CSA was 5.75 mm² at the SG (sensitivity 52.9%, specificity 90%), 1.75 mm² for ΔSx–Asx (sensitivity 58.8%, specificity 100%), and 1.22 mm² for Sx/Asx (sensitivity 70.6%, specificity 93.3%) in diagnosing radial neuropathy at the SG. There was no significant correlation between CSA and electrophysiological severity score for either patient group. CONCLUSION: The reference value obtained for CSA of the radial nerve at the SG may facilitate investigation of radial nerve pathologies at the SG.
Diagnostic Imaging ; Humans ; Pathology ; Radial Nerve ; Radial Neuropathy* ; Reference Values ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Numbness on the hand occurs infrequently after a transradial cardiac catheterization (TRC). The symptom resembles that of neuropathy. We, therefore, investigated the prevalence, the predicting factors and the presence of neurological abnormalities of numbness, using a nerve conduction study (NCS). SUBJECTS AND METHODS: From April to December 2013, all patients who underwent a TRC were prospectively enrolled. From among these, the patients who experienced numbness on the ipsilateral hand were instructed to describe their symptoms using a visual analogue scale; subsequently, NCSs were performed on these patients. RESULTS: Of the total 479 patients in the study sample, numbness occurred in nine (1.8%) following the procedure. The NCS was performed for eight out of the nine patients, four (50%) of which had an abnormal NCS result at the superficial radial nerve. A larger sheath and history of myocardial infarction (p=0.14 and 0.08 respectively) tended towards the occurrence of numbness; however, only the use of size 7 French sheaths was an independent predictor for the occurrence of numbness (odds ratio: 5.50, 95% confidence interval: 1.06-28.58, p=0.042). The symptoms disappeared for all patients but one, within four months. CONCLUSION: A transient injury of the superficial radial nerve could be one reason for numbness after a TRC. A large sheath size was an independent predictor of numbness; therefore, large sized sheaths should be used with caution when performing a TRC.
Cardiac Catheterization* ; Cardiac Catheters* ; Hand ; Humans ; Hypesthesia* ; Myocardial Infarction ; Neural Conduction* ; Prevalence ; Prospective Studies ; Radial Nerve* ; Radial Neuropathy

Cryolipolysis has become available for the noninvasive reduction of adipose tissue. A 33-year-old woman presented with wrist drop of the right arm that had first appeared 7 days previously. She had undergone cryolipolysis on both upper arms immediately prior to the onset of symptoms. A nerve conduction study showed radial neuropathy proximal to the elbow, and ultrasonography revealed focal swelling of the radial nerve at the spiral groove. Although cryolipolysis has been known as a safe method, nerve injury can result from compression and/or hypothermia during the procedure.
Adipose Tissue ; Adult ; Arm ; Elbow ; Female ; Humans ; Hypothermia ; Lipolysis ; Methods ; Neural Conduction ; Radial Nerve ; Radial Neuropathy* ; Ultrasonography ; Wrist

Radial nerve entrapment or compression in the upper extremity is relatively rare compared to medial nerve or ulnar nerve entrapment and compression. Various syndrome types are defined according to the location of radial nerve entrapment and the pattern of symptom expression. In the upper arm, Saturday night palsy or honeymoon palsy occurs. Around the elbow, posterior interosseous nerve entrapment syndrome, which involves pure motor symptoms, and radial tunnel syndrome, which mainly involves pain symptoms, can develop. Finally, superficial radial nerve entrapment occurs in the distal forearm and has the symptom of painful or abnormal sensory disturbances of the hand. Conservative treatment is usually the first choice for radial nerve neuropathy, unless there is motor paralysis. Surgical treatment can be considered if there is no improvement after adequate conservative treatment.
Arm ; Elbow ; Forearm ; Hand ; Nerve Compression Syndromes ; Paralysis ; Radial Nerve* ; Radial Neuropathy ; Ulnar Nerve Compression Syndromes ; Upper Extremity

OBJECTIVETo explore the mechanism and feasibility of the supinator syndrome evoked embitterment test from anatomy and clinic.

METHODS25 cases of The supinator syndrome were reviewed. 18 of them were male and 7 were female. Drop finger deformation were apparent in 25 cases and The supinator syndrome evoked embitterment test was positive for All patients. Operative neurolysis was done in 8 cases, conservation treatment 17 cases; 92 cadaver upper extremities were dissected for a study the relationship between supinator tunnel and posterior interosseous nerve.

RESULTS22 cases had been followed up for an average of 9 months. 16 cases had a full recovery and 6 cases, a partial recovery. the anatomical study shows that The posterior interosseous nerve was compressed by Forhse arcade and the distal border of the supinator muscle during passive pronation forearm.

CONCLUSIONThe supinator syndrome evoked embitterment test was a new test for the diagnosis of supinator syndrome, it was found to be more sensitive and specific than the others test.

Exercise Test ; methods ; Female ; Humans ; Male ; Nerve Compression Syndromes ; diagnosis ; Radial Nerve ; pathology ; Radial Neuropathy ; diagnosis ; pathology ; therapy ; Sensitivity and Specificity

Loss of radial nerve function in the hand results in a significant disability and so cannot extend the wrist, thumb & fingers according to the injury levels. Therefore the patient has great difficulty in grasping objects, especially power grip. Tendon transfers to restore function of extension of wrist and fingers are among the the best − most predictable transfers in the upper extremity. We performed 13 cases of tendon transfers for radial nerve palsy and extensive extensor ruptures from 1987 to 1993. The results were evaluated according to Arbitrary Value Method. Among 13 cases 30% of excellent, 46% of good, 24% of fair and no poor result were obtained and the better results were obtatined in low radial nerve lesion.
Fingers ; Hand ; Hand Strength ; Humans ; Methods ; Paralysis ; Radial Nerve ; Radial Neuropathy ; Rupture ; Tendon Transfer ; Tendons ; Thumb ; Upper Extremity ; Wrist

Thoracic outlet syndrome is caused by the compression of neurovascular structures at the thoracic outlet region. Diagnosis is difficult since thoracic outlet syndrome is often accompanied by distal entrapment neuropathies such as carpal tunnel syndrome or ulnar and radial neuropathies. In this article, the authors report a case regarding a patient with thoracic outlet syndrome whose diagnosis was delayed due to the overlapping of multiple distal entrapment neuropathies.
Carpal Tunnel Syndrome ; Humans ; Nerve Compression Syndromes ; Radial Neuropathy ; Thoracic Outlet Syndrome

BACKGROUND AND PURPOSE: The objective of this study was to determine diagnostic and prognostic values of proximal radial motor conduction in acute compressive radial neuropathy. METHODS: Thirty-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. RESULTS: Thirty-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. CONCLUSIONS: Proximal radial motor conduction appears to be a useful method for the early detection and prediction of prognosis of acute compressive radial neuropathy.
Action Potentials ; Arm ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Prognosis ; Radial Neuropathy*