Radial nerve palsy

Introduction to sacral nerve palsy The phrenic nerve consists of C5~8, which causes damage to the elbow, extension of the wrist, extension of the finger and the thumb of the back of the hand and the first and second metacarpal space. The typical manifestation of sacral nerve palsy is the scapula, because the phrenic nerve is the most vulnerable of the brachial plexus. The upper segment is closely attached to the sacral sulcus on the dorsal side of the middle part of the femur, from the medial side of the upper arm to the lateral side. The femoral shaft is easily damaged when it is fractured, or it is damaged when the epiphysis is formed after the fracture, or the arm is replaced by the arm during sleep. The upper limbs hang over the hard objects, and the placement of the tourniquets on the upper limbs can cause sacral nerve damage. Lead poisoning and alcoholism may also selectively damage the phrenic nerve. basic knowledge The proportion of sickness: 0.002% - 0.005% Susceptible people: no special people. Mode of infection: non-infectious Complications: somatosensory disturbance

Cause of sacral nerve palsy

External force factor (35%)

The phrenic nerve can be paralyzed by the support of the trap in the axillary fossa. The upper part of the sacral nerve is close to the dorsal radial sulcus in the middle part of the humerus. It is from the medial side of the upper arm to the lateral side. When the humeral shaft is fractured, it is easily damaged, or the epiphysis is formed after the fracture. Damaged; the arm is replaced by a pillow during sleep, the upper arm is abducted for a long time during surgery, and the tourniquet is improperly placed on the upper limb.

Poisoning (20%)

Lead poisoning and alcoholism can also selectively damage the phrenic nerve. Lead and alcohol can cause chronic or acute poisoning of the nerves, damage to the nerves, and cause nerve paralysis. Some scholars say that clinical case studies have found that sleeping pills and some neurological drugs can also cause nerve paralysis.

Radial nerve paralysis prevention

Patients with sacral nerve palsy should pay attention to the following points:

1. Give a nutritious and multivitamin-rich diet, give B vitamins, and avoid excessive activities.

2, the acute phase should allow patients to rest properly and avoid excessive activities. At the same time avoid local compression.

3. Give adrenal corticosteroids and apply analgesics if necessary.

4, sacral nerve regeneration ability is good, treatment can be restored, prognosis is good.

Radial nerve palsy complications Complications

When the sacral nerve is damaged, there may be a loss of sensation on the back of the forearm and on the temporal side of the back of the hand, often due to the overlap of the adjacent sensory innervation, and the sensory defect area is limited to the thumb and the very small part of the back of the first and second metacarpals.

Symptoms of phrenic nerve paralysis Common symptoms Sensory disorder Upper extremity abduction lifting difficulty upper limb numb upper limb weakness reflex arc interrupted wrist wrist drooping limb or trunk numb writing or taking small items difficult

1. Movement disorders:

The typical symptoms are sagging of the wrist, 1 high injury (above the triceps branch), complete paralysis of the phrenic nerve, complete extensor of the upper extremity, elbow, wrist, metacarpophalangeal joint can not be straight, forearm straight When the time can not be rotated, the front of the hand is rotated, the tendon tendon can not bend the elbow joint in the semi-rotation position; 2 1/3 of the humerus (below the triceps branch) is damaged, and the triceps function is intact; 3 Injury of the lower end of the tibia or the upper third of the forearm, the diaphragm, the supinator, and the function of the wrist muscle; 4 of the forearm with less than 1/3 of the injury, only the index finger, no wrist; 5 close to the wrist injury (each Exercise branches have been issued), no paralysis of the nerves.

2. Sensory symptoms: only the back of the hand and the first and second metacarpal space are sensory.

Check of sacral nerve palsy

Nerve damage is characterized by EMG and neuromuscular electrograms:

1 Complete damage: There is self-generating activity, no MU P, CMA, PSNA, PMNCV disappear.

2 Severe damage: There is self-generating activity, no MU P, CMA P amplitude decreases, SNA P decreases or disappears, and MNCV slows or disappears.

3 Incomplete damage: There may be self-generating activity or insertion potential extension, MU P decreases, CMA P decreases S, NA P decreases, and MNCV is normal or slow.

Conditional hospitals can be used as routine examinations for nerve damage. During the recovery process after nerve injury, it is feasible to monitor the EMG and observe the nerve regeneration to provide surgical indications.

Diagnosis and differentiation of phrenic nerve paralysis

diagnosis

Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.

Differential diagnosis

(1) musculocutaneous neuropathy: mainly showing biceps and upper arm muscle atrophy, upper arm flexion side flat, elbow joint flexion weakening, anterior wall showing external rotation position, unable to flex the elbow joint, forearm rotation restricted, biceps biceps, the biceps tendon reflex disappeared, the anterior wall was dysfunctional, and the periosteal reflex was weakened or disappeared.

(B) Arm paralysis from the nerve: upper arm plexus injury, upper arm can not be abducted, forearm can not flex, arm can not be external rotation, forearm can not be rotated, arm straight extension is internal rotation and internal retraction, sensory obstacle is not obvious, shoulder and upper arm With muscle atrophy, biceps, periosteal reflexes weakened or disappeared, lower wall clumps fingers can not flex, fingers can not be abducted and adducted, thumb can not flex, adduction, abduction, little finger can not do the palm movement, forearm And the ulnar side of the hand has a feeling of decline, the size of the fish atrophy, hand edema, cyanosis, nails become brittle, may have Horner's sign, face, neck sweating abnormal.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.