title: Overriding fifth finger: an unusual sign in lower brachial plexopathy.
abstract: Hand deformities are often useful clinical signs. To our knowledge, they have not been described in association with brachial plexus lesions. A 28-year-old female presented with sudden left shoulder pain and medial forearm parasthesia. Examination showed the left fifth finger adducting and flexing over the dorsal aspect of the fourth finger. Neurophysiological studies and MRI supported a brachial plexus lesion. The physical sign was not present 5 months post onset and the patient experienced near complete clinical improvement. The unusual physical sign occurred in association with neuralgic amyotrophy. Its occurrence can be explained in terms of transient patchy involvement of nerve fascicles in the brachial plexus.
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. gnrlyl@sgh.com.sg
authors.forename: Y L
authors.initials: YL
authors.lastname: Lo
authors.forename: L L
authors.initials: LL
authors.lastname: Chan
authors.forename: S H
authors.initials: SH
authors.lastname: Tan
authors.forename: C T
authors.initials: CT
authors.lastname: Tan
mesh_terms: D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D005385:Fingers / Q000002:abnormalities* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009482:Neurophysiology / Q000379:methods