Iatrogenic selective lesion of the median nerve at the elbow.
A lesion of the median nerve may occur as a consequence of a compression by a haematoma or for a direct damage of the axons caused by a needle insertion. To date, no investigation reported a very selective lesion of the median nerve at the elbow, with the suffering limited only to the fibres for the first digit. A 53 year-old left-handed violinist underwent an arterial blood gas drawing. The patient complained immediately of an electrical shock impression going down the arm, followed by pin sensation into the first finger. A tingling sensation associated with numbness in the first fingertip and difficulty in the index-thumb pinch became progressively evident. The ENG-EMG findings showed an impairment mainly of the sensory fibres innervating the first digit and a drop of the motor action potential amplitude when the nerve was stimulated at the elbow. We reported a very partial lesion of the left median nerve at the elbow in a violinist who had a selective involvement of the fibres for his first digit. Even minimal lesions of the median nerve may impair severely the quality of life of patients.
Di Fabio
Roberto
R
Department of Neurology and ORL, Sapienza University of Rome-Polo Pontino Latina, Italy. rob.dif@tiscali.it
Casali
Carlo
C
Pierelli
Francesco
F
D001707:Biopsy, Needle / Q000009:adverse effects*; D004550:Elbow / Q000294:innervation* / Q000503:physiopathology; D004576:Electromyography; D006801:Humans; D007049:Iatrogenic Disease; D008279:Magnetic Resonance Imaging; D020423:Median Neuropathy / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology