Peripheral nerve syndromes

Clinical Features

Peripheral nerve syndromes

  • Upper extremity
    • Ulnar
      • Cause of Injury: Elbow injury.
      • Sensory changes in the 5th and medial half of 4th digits, weak wrist flexors, “claw hand”
    • Radial
    • Median, distal
      • Cause of Injury: Wrist dislocation, laceration, Carpal Tunnel Syndrome
      • Weak flexion of radial half of digits and thumb, loss of abduction and opposition of thumb. Ape hand deformity, benediction sign. Loss of sensation of lateral three and one-half digits and nail beds
    • Median, proximal
    • Musculocutaneous
      • Cause of Injury: Anterior shoulder dislocation, entrapment due to hypertrophy
      • Elbow flexion and supination weakness, radial forearm sensory deficits
    • Axillary
    • Suprascapular
      • Cause of Injury: Paralabral cyst, bone/soft tissue tumor, Scapular fracture, traction injury, Parsonage-Turner syndrome
      • Weak arm abduction to 90 degrees, weak shoulder flexion to 30 degrees, weak internal rotation
  • Lower extremity
    • Femoral
      • Cause of Injury: Pubic rami fracture, pelvic fractures
      • Weak knee extension, anterior knee sensory deficits
    • Obturator
    • Posterior tibial
      • Cause of Injury: Knee dislocation
      • Weak toe flexion, plantar foot sensory deficit
    • Superficial peroneal
      • Cause of Injury: Fibular neck fracture, knee dislocation
      • Weak ankle eversion, lateral dorsal foot sensory deficits
    • Deep peroneal
      • Cause of Injury: Fibular neck fracture, compartment syndrome
      • Sensory deficit at dorsal 1st web space, weak ankle and toe dorsiflexion
    • Sciatic
      • Cause of Injury: Posterior hip dislocation
      • Lower leg weakness, foot drop, leg sensory deficits
    • Superior gluteal
      • Cause of Injury: Acetabular pelvic fracture
      • Trendelenburg’s gait, Trendelenburg’s sign
    • Inferior gluteal
      • Cause of Injury: Acetabular pelvic fracture, s/p hip replacement
      • Abnormal gait, gluteus maximus weakness resulting in gluteus maximus lurch

Differential Diagnosis

Upper extremity peripheral nerve syndromes

Median Nerve Syndromes

Ulnar Nerve Syndromes

  • Ulnar neuropathy at the elbow and wrist

Radial Nerve Syndromes

Proximal Neuropathies

Other

Extremity trauma

Evaluation

See Also

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