title: Low Median Nerve Palsy as Initial Manifestation of Churg-Strauss Syndrome.
abstract: Anterior interosseous nerve (AIN) syndrome is typically characterized by forearm pain and partial or complete dysfunction of the AIN-innervated muscles. Although the exact etiology and pathophysiology of the disorder remain unclear, AIN syndrome is increasingly thought to be an inflammatory condition of the nerve rather than a compressive neuropathy because the symptoms often resolve spontaneously following prolonged observation. However, peripheral neuropathy can be 1 of the first symptoms of systemic vasculitis that needs early systemic immunotherapy to prevent extensive nerve damage. Churg-Strauss syndrome (CSS; eosinophilic granulomatosis with polyangiitis) is 1 type of primary systemic vasculitis that frequently damages the peripheral nervous system. CSS-associated neuropathy usually involves nerves of the lower limb, and few studies have reported on the involvement of the upper limb alone. We report on a rare case of low median nerve palsy as the initial manifestation of CSS. The patient recovered well with early steroid treatment for primary systemic vasculitis.
authors.affiliation: Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Roh
authors.affiliation: Department of Orthopaedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Young Do
authors.initials: YD
authors.lastname: Koh
authors.affiliation: Department of Orthopaedic Surgery, Kangwon National University Hospital, Gangwon-do, Korea. Electronic address: bestknee@hotmail.com.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Noh
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D015267:Churg-Strauss Syndrome / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020423:Median Neuropathy / Q000209:etiology*; D008875:Middle Aged
keywords: Anterior interosseous nerve syndrome; Churg-Strauss syndrome; steroid treatment; systemic vasculitis