Palmar Digital Neuropathy With Anatomical Variation of Median Nerve: Usefulness of Orthodromic Technique: A Case Report
- Authors
- Noh, Jun Soo; Park, Jong Woong; Kwon, Hee-Kyu
- Issue Date
- 6월-2019
- Publisher
- KOREAN ACAD REHABILITATION MEDICINE
- Keywords
- Median nerve; Electrodiagnosis; Carpal tunnel syndrome; Median neuropathy
- Citation
- ANNALS OF REHABILITATION MEDICINE-ARM, v.43, no.3, pp.341 - 346
- Indexed
- SCOPUS
KCI
- Journal Title
- ANNALS OF REHABILITATION MEDICINE-ARM
- Volume
- 43
- Number
- 3
- Start Page
- 341
- End Page
- 346
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/65330
- DOI
- 10.5535/arm.2019.43.3.341
- ISSN
- 2234-0645
- Abstract
- Anatomic variation of palmar digital nerve pathways were reported in several cases. Selective exploration of palmar digital nerves with a nerve conduction study has been challenging, because of technical issues. We report a patient who received bilateral carpal tunnel release operation, complaining of a tingling sensation, and hypoesthesia on the middle and ring fingers. An electrodiagnostic study revealed a sensory neuropathy of palmar digital nerve of the left median nerve, supplying the ulnar side of the middle finger, and radial side of the ring finger. She underwent re-operation of open left carpal tunnel release, and a branching site of common digital nerves of the median nerve was identified not at the palm, but at a far proximal site around the distal wrist crease. Usefulness of an orthodromic sensory conduction study was clarified to eliminate volume conducted response or co-activation of nearby nerves in the patient with selective involvement of palmar digital nerve.
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