Radial Neuropathy
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Radial neuropathy is a type of mononeuropathy which results from acute
trauma Trauma most often refers to: * Major trauma, in physical medicine, severe physical injury caused by an external source * Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic i ...
to the radial nerve that extends the length of the arm. It is known as transient paresthesia when sensation is temporarily abnormal.


Signs and symptoms

Symptoms of radial neuropathy vary depending on the severity of the trauma; however, common symptoms may include
wrist drop Wrist drop is a medical condition in which the wrist and the fingers cannot extend at the metacarpophalangeal joints. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. As a result, the extensor muscles ...
,
numbness Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as num ...
on the back of the hand and wrist, and inability to voluntarily straighten the fingers. Loss of wrist extension is due to loss of the ability to move of the posterior compartment of
forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is most often used to describe the entire appendage of the upper limb, but which in ...
muscles. In the event of lacerations to the wrist area the symptom would therefore be sensory. Additionally, depending on the type of trauma, other nerves may be affected such as the
median nerve The median nerve is a nerve in humans and other animals in the upper limb. It is one of the five main nerves originating from the brachial plexus. The median nerve originates from the lateral and medial cords of the brachial plexus, and has cont ...
and axillary nerves.


Causes

There are many ways to acquire radial nerve neuropathy, including: :::::::::::*Upper arm - a fracture of the bone :::::::::::*Elbow - entrapment of the nerve :::::::::::*Wrist -
elbow The elbow is the region between the arm and the forearm that surrounds the elbow joint. The elbow includes prominent landmarks such as the olecranon, the cubital fossa (also called the chelidon, or the elbow pit), and the lateral and the me ...
deformity and
soft-tissue Soft tissue is all the tissue in the body that is not hardened by the processes of ossification or calcification such as bones and teeth. Soft tissue connects, surrounds or supports internal organs and bones, and includes muscle, tendons, ligam ...
masses :::::::::::*Axilla - here the most common cause is compression. However, a dislocation of the
humerus The humerus (; ) is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a roun ...
is a possible factor as well. It could also be due to
brachial plexus The brachial plexus is a network () of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve ( C5, C6, C7, C8, and T1). This plexus extends from the spinal cord, through the cervicoaxillary canal in t ...
compression.


Mechanism

The mechanism of radial neuropathy is such that it can cause focal
demyelination A demyelinating disease is any disease of the nervous system in which the myelin sheath of neurons is damaged. This damage impairs the conduction of signals in the affected nerves. In turn, the reduction in conduction ability causes deficiency i ...
and
axonal An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see spelling differences), is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as action po ...
degeneration. These would be caused via laceration or compression of the nerve in question.


Diagnosis

Radial neuropathy may be diagnosed using
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
,
ultrasound Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...
,
nerve conduction study A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. These tests may be performed by medical speci ...
or electromyography (EMG).


Treatment

The treatment and management of radial neuropathy can be achieved via the following methods: * Physical therapy or occupational therapy * Surgery (depending on the specific area and extent of damage) :*
Tendon A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
transfer (the origin remains the same but insertion is moved) * Splinting


Prognosis

Radial neuropathy is not necessarily permanent, though there could be partial loss of movement or
sensation Sensation (psychology) refers to the processing of the senses by the sensory system. Sensation or sensations may also refer to: In arts and entertainment In literature * Sensation (fiction), a fiction writing mode * Sensation novel, a Britis ...
. Complications include deformity of the hand in some individuals. If the injury is
axonal An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see spelling differences), is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as action po ...
(the underlying nerve fiber itself is damaged), recovery may take months or years and full recovery may never occur. EMG and
nerve conduction studies A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. These tests may be performed by medical spec ...
are typically performed to diagnose the extent and distribution of the damage, and to help with prognosis for recovery.


Culture and society

There are a number of terms used to describe radial nerve injuries, which are dependent on the causation factor such as: * ''Honeymoon palsy'' from another individual sleeping on and compressing one's arm overnight. * ''Saturday night palsy'' from falling asleep with one's arm hanging over the arm rest of a chair, compressing the radial nerve. * ''Squash palsy'', from traction forces associated with the sport
squash Squash may refer to: Sports * Squash (sport), the high-speed racquet sport also known as squash racquets * Squash (professional wrestling), an extremely one-sided match in professional wrestling * Squash tennis, a game similar to squash but pla ...
, happens to squash players during periods between matches.


See also

* Crutch paralysis *
Peripheral neuropathy Peripheral neuropathy, often shortened to neuropathy, is a general term describing disease affecting the peripheral nerves, meaning nerves beyond the brain and spinal cord. Damage to peripheral nerves may impair sensation, movement, gland, or or ...


References


Further reading

* *


External links

{{Medicine Peripheral nervous system disorders Symptoms and signs: Nervous system Mononeuropathies of upper limb