Compression of the deep branch of the ulnar nerve in Guyon's canal by a ganglion: two cases.
BACKGROUND
Ulnar nerve compression at the wrist can be caused by a variety of intrinsic and extrinsic factors. Isolated compression of only the deep branch of ulnar nerve by a ganglion is very uncommon. Ultrasound examination can clearly show the cystic lesion compressing the nerves.


METHODS
We present two cases of compression of deep branch of ulnar nerve by a ganglion in the Guyon's canal. Two male patients presented with history of progressive weakness and paraesthesia in the medial 1(1/2) digits of the non-dominant hand. Interestingly, both the patients noticed sudden onset and rapid progress of the symptoms and signs. Clinical examination revealed typical symptoms of ulnar nerve (deep branch) palsy. Nerve conduction studies showed severe denervation of the deep branch of the ulnar nerves in both the patients and ultrasound confirmed the diagnosis. Surgical decompression led to complete recovery.


CONCLUSIONS
Whilst compression by a ganglion in the Guyon's canal is rare but well recognized, a feature of both of our cases was the rapid progression and severe nature of the compressive symptoms and signs. This is in contrast to the more typical features of compressive neuropathy and should alert the clinician to the possible underlying cause of compression. Early decompression has the potential to promote a complete recovery.
Inaparthy
P K
PK
West Middlesex University Hospital, Isleworth, West Middlesex, UK. i_praveen@yahoo.com
Anwar
F
F
Botchu
R
R
Jähnich
H
H
Katchburian
M V
MV
D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D004576:Electromyography; D005500:Follow-Up Studies; D045888:Ganglion Cysts / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology; D009431:Neural Conduction; D020127:Recovery of Function; D018570:Risk Assessment; D016896:Treatment Outcome; D017769:Ulnar Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014463:Ultrasonography