Palmar Digital Neuropathy With Anatomical Variation of Median Nerve: Usefulness of Orthodromic Technique: A Case Report
10.5535/arm.2019.43.3.341
- Author:
Jun Soo NOH
1
;
Jong Woong PARK
;
Hee Kyu KWON
Author Information
1. Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea. hkkwon@korea.ac.kr
- Publication Type:Case Report
- Keywords:
Median nerve;
Electrodiagnosis;
Carpal tunnel syndrome;
Median neuropathy
- MeSH:
Anatomic Variation;
Carpal Tunnel Syndrome;
Electrodiagnosis;
Fingers;
Humans;
Hypesthesia;
Median Nerve;
Median Neuropathy;
Neural Conduction;
Sensation;
Wrist
- From:Annals of Rehabilitation Medicine
2019;43(3):341-346
- CountryRepublic of Korea
- Language:English
-
Abstract:
Anatomic variation of palmar digital nerve pathways were reported in several cases. Selective exploration of palmar digital nerves with a nerve conduction study has been challenging, because of technical issues. We report a patient who received bilateral carpal tunnel release operation, complaining of a tingling sensation, and hypoesthesia on the middle and ring fingers. An electrodiagnostic study revealed a sensory neuropathy of palmar digital nerve of the left median nerve, supplying the ulnar side of the middle finger, and radial side of the ring finger. She underwent re-operation of open left carpal tunnel release, and a branching site of common digital nerves of the median nerve was identified not at the palm, but at a far proximal site around the distal wrist crease. Usefulness of an orthodromic sensory conduction study was clarified to eliminate volume conducted response or co-activation of nearby nerves in the patient with selective involvement of palmar digital nerve.
