There will be no weakness associated with Wartenberg syndrome. Demiryürek BE, Emre U, Demirel EA, Taşçılar FN, Atasoy HT, Ortancıl Ö, et al. İstanbul Med J. Although most people with Waardenburg syndrome have normal hearing, moderate to profound hearing loss can occur in one or both ears. The two conditions may be related. 271(1-2):75-9. EMG may not be positive for 3-6 weeks following injury. Braidwood AS. An injection of cortisone and lidocaine into the area of compression of the superficial radial nerve causes the symptoms to subside; however, numbness in the nerve distribution follows, and when the injection wears off, the symptoms return. 2012 Apr;16(2):129-36. doi: 10.1055/s-0032-1311764. This commonly results from weakness of some of the ulnar nerve innervated intrinsic hand muscles-in particular the palmar interosseous muscle to the little finger- caused by damage to their nerve supply (denervation). In this condition,the patient reports pain over the distal radial forearm associated with paresthesias over the dorsal radial hand.This should not be confused with Wartenberg's Sign which refers to the slightly greater abduction of the fifth digit, due to paralysis of the abducting palmar inter… Jengojan S, Kovar F, Breitenseher J, Weber M, Prayer D, Kasprian G. Acute radial nerve entrapment at the spiral groove: detection by DTI-based neurography. There will be no weakness associated with this condition. The role of corticosteroid injection is less clear. All electrodiagnostic test results are within normal limits in radial tunnel syndrome. Since its original description in 1958 by Wartenberg et al, 1 very few cases have been reported 2 –12 supporting it being a rare disorder. Compression of the nerve resulted in a transient increase in local radial nerve fractional anisotropy values. Radial sinir nöropatilerinin retrospektif değerlendirilmesi. If the medial branch of the posterior interosseous nerve is compressed, EMG and conduction studies reveal abnormal function of the extensor carpi ulnaris, the extensor digitorum communis, and the extensor digiti quinti. Lo YL, Fook-Chong S, Leoh TH, Dan YF, Tan YE, Lee MP, et al. Axonal swelling and hypoechogenicity of the nerve was diagnosed in 15 cases, loss of continuity of a nerve bundle in 17, formation of a neuroma of a stump in 6, and partial laceration of a nerve with loss of the normal fascicular pattern in 5. The later involves compression at the wrist of the superficial sensory branch of the radial nerve which does not innervate hand muscles. Dang AC, Rodner CM: Unusual compression neuropathies of the forearm, Part I: radial nerve. The superficial branch of the radial nerve is easily injured by trauma. The ulnar nerve bifurcates into the superficial and deep branches. But your doctor may suggest additional tests if you get a positive sign and have other symptoms of conditions like MS, ALS, hyperthyroidism, or … The superficial branch of the radial nerve has 3 or 4 terminal branches and is a purely sensory nerve as indicated by the shaded area. Djurdjevic T, Loizides A, Loscher W, Gruber H, Plaikner M, Peer S. High resolution ultrasound in posterior interosseous nerve syndrome. Wartenberg’s syndrome is caused by entrapment of the superficial branch of the radial nerve at this point when the nerve arises from beneath the muscles. [10], Wilkinson, Iain and Lennox, Graham (June 2005). Common symptoms reported by people with Wartenberg's syndrome Robert Wartenberg (1887-1956) was a neurologist born in Belarus who worked in Germany until 1935 when he emigrated to the United States. Robert Wartenberg (1887-1956) was a neurologist born in Belarus who worked in Germany until 1935 when he emigrated to the United States. 2009 Jun. The superficial branch of the radial nerve passes along the front of the radial side of the forearm beneath the brachioradialis muscle. Ultrasound is helpful in distinguishing Wartenberg’s syndrome from de Quervain’s tenosynovitis or arthritis of the trapeziometacarpal joint 5). The site of compression is localized by all function proximal to the compression being normal and all function distal to the compression being abnormal. 25 (6):1678-83. Lo et al 14) compared ultrasonography with electrophysiologic testing in the diagnosis of entrapment neuropathy of the radial nerve at the spiral groove, which is relatively common but technically challenging to localize. 2008 Aug 15. This commonly results from weakness of some of the ulnar nerve innervated intrinsic hand muscles -in particular the palmar interosseous muscle to the little finger- caused by damage to their nerve supply (denervation). Magnetic resonance imaging (MRI) is useful in detecting tumors such as lipomas and ganglions, as well as aneurysms and rheumatoid synovitis. Surgical exploration may be necessary if conservative therapy fails 18). New York: McGraw-Hill; 1989, pp125-130, Lanzetta M, Foucher G: Entrapment of the superficial branch of the radial nerve (Wartenberg’s syndrome): a report of 52 cases. The Finkelstein test may be positive due to traction on the nerve or associated with de Quervain’s tenosynovitis. Wartenberg syndrome symptoms. Wartenberg's sign is not a feature of, and should not be confused with, Wartenberg's syndrome. Surgical decompression may also be indicated in post-traumatic situations in which scar tissue may be the critical compressive factor 23). 2014;49:35–39. In de Quervain disease, injection of cortisone and lidocaine into the tendon sheath of the extensor pollicis brevis and the abductor pollicis longus relieves the symptoms immediately and sometimes permanently. 1975;57:380–383. The inability to perform adducted digital extension is due to weakness in ulnar innervated intrinsic muscles, and the unopposed action of the slightly medially attached extensor digiti minimi results in extension and abduction of the 5th digit. Wartenberg syndrome symptoms include burning type pain at proximal forearm and hand dorsoradial, hypoesthesia, numbness and tingling at hand dorsum and thumb radial side are observed. Ultrasonography correctly identified all six patients with radial neuropathy; the four patients with other diagnoses did not show ultrasound abnormalities. enable_page_level_ads: true Lanzetta and Foucher 21) reported a 71% success rate in 29 patients who underwent conservative treatment alone, which was defined as removal of a tight watch strap, splinting, and, in 3 cases, a corticosteroid therapy. Wartenberg syndrome also called isolated superficial radial neuropathy or cheiralgia paresthetica, is an entrapment neuropathy of the superficial branch of the radial nerve at the level of the distal forearm and wrist 1). J Ultrasound Med. Any cutaneous sensory nerve can be involved with patients usually showing a slow start, building up to sensations in many parts of the body. Symptoms vary substantially within types, but Type 3 tends to be the most debilitating. These findings may not become abnormal for 3-6 weeks after injury. The presence of a neuroma produces a guarded prognosis for recovery and relief 20). High-resolution ultrasound may depict the abnormal changes of the superficial branch of the radial nerve 6). Toros T, Karabay N, Ozaksar K, Sugun TS, Kayalar M, Bal E. Evaluation of peripheral nerves of the upper limb with ultrasonography: a comparison of ultrasonographic examination and the intra-operative findings. Sometimes the innervation area of the superficial radial nerve can overlap with the innervation of the lateral antebrachial cutaneous nerve. p. 1184, "Nerves of the Arm: Some of Their Affections; Their Diagnosis", "A review of clinical tests and signs for the assessment of ulnar neuropathy", "Ulnar Neuropathy: Background, Anatomy, Pathophysiology", "Myelopathy hand. google_ad_client: "ca-pub-9759235379140764", }); Tagliafico A, Cadoni A, Fisci E, Gennaro S, Molfetta L, Perez MM, et al. Cheiralgia Paresthetica: An Isolated Neuropathy of the Superficial Branch of the Radial Nerve. The superficial branch of the radial nerve can be injured during the placement of fixator pins due to Colles fractures. Symptoms of type 2 . SUMMARY Six cases are reported that conform to Wartenberg's description of migrant sensory neuritis. Most symptoms resolve but permanent sensory loss can persist. The Nerve 2015; 1(1): 1-5. https://www.thenerve.net/upload/pdf/nerve-2015-1-1-1.pdf, Serçe A, Karaca Umay E, Karaahmet ÖZ, Çakcı FA. The superficial sensory branch of the radial nerve is purely sensory, runs under cover of the brachioradialis in the forearm. In half o… Symptoms [edit | edit source] Positive Tinel's sign is often present. An unexpected side effect: Wartenberg syndrome related to the use of splint during carpal tunnel syndrome treatment. It divides into a medial branch and a lateral branch to innervate the radial wrist (with some variable overlap from the lateral antebrachial cutaneous nerve), dorsal radial hand, and dorsum of the radial three-and-a-half digits (to approximately the middle phalanx level). Symptoms of type 3. Wartenberg’s syndrome is more common to occur in women. Superficial radial neuropathy. 2017;64(1):83–86. Epub 2012 May 30. De quervain tenosynovitis of the wrist. Wartenberg neuritis is a pure sensory mononeuropathy characterized by sudden sensory loss and numbness of cutaneous nerves induced by stretch or trauma.