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radial nerve palsy; radial nerve entrapment; wrist drop; Saturday night palsy
Etiology:
- injury caused by
- improper use of crutches
- fracture of the humerus
- pressure at the wrists
- chronic or repetitive constriction of the wrist (wristband)
- swelling or injury of nearby structures
- pressure to the upper arm
- hanging the arm over the back of a chair (Saturday night palsy if alcohol related)
- arm positions during sleep or coma
- idiopathic Clinica manifestations:
- abnormal sensations
- back of the hand
- radial surface of the hand
- 2nd & 3rd fingers
- difficulty straightening the arm at the elbow
- difficulty with supination of the arm
- difficulty with dorsiflexion at the wrist or wrist drop
- muscular atrophy in the forearm
- paresthesias
- pain
Special laboratory:
- electromyogram
- nerve conduction studies
- nerve biopsy (rarely needed)
Radiology:
- magnetic resonance imaging (MRI) of the head, neck, & shoulder to look for other causes
Management:
- correct underlying etiology or behavior
- surgery to remove masses that compress the radial nerve
- analgesics to control pain
- anticonvulsant medicines may reduce stabbing pain
- glucocorticoid injections around the nerve to reduce swelling may help some patients
- braces, splints, or other appliances map help in severe cases
- physical therapy
- occupational therapy to suggest changes in the home or at the worksite
- prognosis:
- most cases will fully recover
- in more severe cases, there may be partial or complete loss of movement or sensation
Related
radial nerve
General
entrapment neuropathy; nerve entrapment syndrome; pinched nerve
References
- PubMed Health:Radial nerve dysfunction
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001794/
- Stern M
eMedicine: Radial Nerve Entrapment
http://emedicine.medscape.com/article/1244110-overview