Clinical Features of Wrist Drop Caused by Compressive Radial Neuropathy and Its Anatomical Considerations

Journal of Korean Neurosurgical Society 2014³â 55±Ç 3È£ p.148 ~ p.151

ÇѺ¸¶÷(Han Bo-Ram) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
Á¶¿µÁØ(Cho Yong-Jun) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
¾çÁø¼­(Yang Jin-Seo) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
°­¼÷Çü(Kang Suk-Hyung) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
ÃÖÇõÀç(Choi Hyuk-Jai) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery

Abstract

Objective: Posture-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.

Methods: Retrospectively, 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.

Results: Subjects 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.

Conclusion: Wrist 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.

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Radial nerve, Entrapment syndrome, Posterior interosseous nerve, Superficial radial nerve, Arcade of Frohse
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