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Radial nerve dysfunction
Alternative namesNeuropathy - radial nerve ; Radial nerve palsy
DefinitionRadial nerve dysfunction involves impaired movement or sensation of the back of the arm (triceps), the forearm, or the hand caused by damage to the radial nerve.
Causes, incidence, and risk factors
Radial nerve dysfunction is a form of peripheral neuropathy . It occurs when there is damage to the radial nerve, which travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. It also provides extension to the wrist and helps in movement and sensation of the wrist and hand.
The usual causes are direct trauma, prolonged pressure on the nerve, or compression of the nerve caused by swelling or injury of nearby body structures. Entrapment involves pressure on the nerve where it passes through a narrow structure.
A more common cause of radial nerve dysfunction is trauma that occurs in the upper arm, such as a fracture of the humerus (upper arm bone) or pressure to the upper arm from arm positions during sleep or coma .
"Saturday-night palsy" is a term for an injury that occurs to the radial nerve during deep sleep, such as that which may occur when a person is intoxicated. Prolonged or repeated constriction of the wrist (caused by wearing a tight watch strap, for example) can also cause an injury to terminal portions of the radial nerve.
In some cases, no detectable cause can be identified. These mechanical factors may be complicated by ischemia (lack of oxygen from decreased blood flow) in the area.
Symptoms can affect the following:
The following symptoms may occur:
Signs and tests
A neuromuscular examination of the arm, hand, and wrist can identify radial nerve dysfunction. There may be weakness of the wrist and finger extension muscles (with decreased ability to extend the arm at the elbow), a minor decreased ability to rotate the arm outward (supination), and difficulty lifting the wrist or fingers (extensor muscle weakness ).
Wrist drop or finger drop may be present, or there may be atrophy (muscle loss) of some of the muscles of the forearm. A detailed patient history may be needed to determine the possible cause of the neuropathy. Rarely, radial nerve dysfunction may be difficult to differentiate from a stroke in the brain.
The treatment is aimed at maximizing the ability to use the hand and arm. The cause should be identified and treated as appropriate. In most cases, no treatment is required and recovery is spontaneous.
Whenever possible, use of medications should be avoided or minimized to reduce the risk of medication side effects.
Expectations (prognosis)If the cause of the nerve dysfunction can be identified and successfully treated, there is a possibility of full recovery. The extent of disability varies from no disability to partial or complete loss of movement or sensation. Nerve pain may be quite uncomfortable and may persist for a prolonged period of time. If this occurs, see a pain specialist to ensure you have access to all options for pain treatment.
Calling your health care providerCall your health care provider if symptoms of radial nerve dysfunction develop.
PreventionThe prevention varies depending on the cause. Avoid prolonged pressure on the upper arm.
Update Date: 7/28/2002Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT