Ulnar nerve
February 27, 2011 | 10,00 EUR | answered by Uni-Arzt Freddy Feuerstein
Dear Dr. [Last Name],
Are lesions on the ulnar nerve, which cause severe pain including clinical symptoms, always clearly evidenced by neurophysiological measurements, or can lesions with severe pain on the ulnar nerve also exist when the measurements are "normal"?
Sincerely,
[Your Name]
Dear Seeker,
The ulnar nerve lesion is primarily a clinical diagnosis, meaning the ulnar nerve is not functioning properly if you experience pain in the sensory supply area of the nerve, if certain muscles no longer function properly, receiving their commands from the ulnar nerve.
The classic presentation is the so-called claw hand, as well as a positive Fromnet sign.
If you want to see a "claw hand", search the term on Google Images.
The Fromnet sign indicates atrophy of a muscle supplied by the thumb and you are unable to tear a piece of paper properly with the affected hand. (Google Images can also help here)
Most ulnar nerve lesions are due to pressure injuries at the elbow or wrist. These can result from a fracture or paralysis due to faulty positioning during anesthesia.
Sometimes, the ulnar nerve can also dislocate from its bony canal at the elbow (luxation) or be damaged by inflammation or chronic overuse, for example, from repetitive lever-like movements. This is known as cubital tunnel syndrome. (Sulcus means canal)
There can also be nerve damage at the wrist under a specific band (the palmar carpal ligament), known as Guyon's canal syndrome.
Sometimes, small pieces of bone (osteophytes) can be found in the nerve canal, which can also lead to a lesion.
Treatment depends on the cause, but it is always advisable to rest the affected arm. In the case of cubital tunnel syndrome, surgery may be necessary to reposition the nerve.
Distinguishing between ulnar nerve lesions and a herniated disc in the cervical spine can also be done through a clinical examination by your neurologist.
Electrophysiological studies can provide clues to damage, but in my opinion, they are not decisive if you have clinical symptoms! Therefore, in this case, I believe further diagnostic testing/surgical intervention is more appropriate, as the function of the arm is crucial and should not be taken lightly.
I hope I could help you, if you have any specific questions, please feel free to ask.
Please also specify what you understand by clinical symptoms or what you specifically have, besides pain.
This response cannot replace a detailed medical consultation, and is based solely on the information you provided.
I wish you a speedy recovery and a nice Sunday.
Kind regards,
Torben C. Müller
