NEUROPATHY-UPPER LIMB
SUMMARY
1. Median: carpal tunnel syndrome. NCS: sensory latencies increase then motor, later axonal loss → reduced amplitude & muscle wasting.
2. Ulnar: compression at elbow. Deep branch in palm compressed with bicycling/tools. NCS: use 1st dorsal interosseous recording.
3. Radial: crutches in axilla crushes the nerve in spiral groove of humerus (Saturday night palsy). present(s) with wrist drop but flexion preserved (vs C7 radiculopathy in which both are affected).
4. Brachial neuritis (inflammatory plexopathy): unilateral shoulder pain followed by weakness e.g. after carrying heavy backpack/post-infectious. Widespread patchy NCS/EMG changes including the long thoracic nerve, which leads to scapular winging.
5. Suprascapular neuropathy: may occur in athletes. Only supra and/or infraspinatus involved.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
