Concomitant Neuropathy of Recurrent Motor Branch of Median Nerve in Carpal Tunnel Syndrome: A Case Report
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Selective fascicular involvement of median nerve in carpal tunnel syndrome (CTS) has been reported, such as predominant involvement of volar-radially located motor and sensory fibers to thumb. Also, recurrent motor branch (RMB) of median nerve could be affected separately. A man has suffered from right-hand weakness and mild tingling sense on I to III digits visited. Thenar muscles wasting and weakness were noted without sensory loss. Whereas the results of sensory conduction and comparison of median-second-lumbrical/ulnar-interossei studies suggested mild CTS, motor responses revealed severe neuropathy. The patient was diagnosed with right CTS, mild degree and concomitant incomplete but severe neuropathy of RMB. The patient underwent an operation. The RMB was found as the transligamentous type with a degenerative change and severely compressed by ligament and thenar muscles. Open carpal tunnel release and decompression with neurolysis were done. Through precise analysis of electrodiagnostic findings, correct diagnosis and proper management were achieved.
Abstract
Selective fascicular involvement of median nerve in carpal tunnel syndrome (CTS) has been reported, such as predominant involvement of volar-radially located motor and sensory fibers to thumb. Also, recurrent motor branch (RMB) of median nerve could be affected separately. A man has suffered from right-hand weakness and mild tingling sense on I to III digits visited. Thenar muscles wasting and weakness were noted without sensory loss. Whereas the results of sensory conduction and comparison of median-second-lumbrical/ulnar-interossei studies suggested mild CTS, motor responses revealed severe neuropathy. The patient was diagnosed with right CTS, mild degree and concomitant incomplete but severe neuropathy of RMB. The patient underwent an operation. The RMB was found as the transligamentous type with a degenerative change and severely compressed by ligament and thenar muscles. Open carpal tunnel release and decompression with neurolysis were done. Through precise analysis of electrodiagnostic findings, correct diagnosis and proper management were achieved.
참고문헌 (10)
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