Symptom >> Internal Medicine >> Neurology

Decreased grip strength

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Cervical spondylotic radiculopathy manifests as neck, shoulder, back pain or acid, pain, acupuncture or burning pain, limited neck activity, upper limbs may have depression, weakness, numbness, decreased grip strength, muscle atrophy, etc. .

Cause

Cause

The narrowing of the intervertebral foramen is caused by compression of the cervical spinal nerve, which is more common in the 4-7 cervical vertebrae; the protrusion or prolapse of the nucleus pulposus, the bone hyperplasia or traumatic arthritis of the posterior small joint, the formation of the spur of the hook joint, and the adjacent three Loosening and displacement of the joints (intervertebral joints, hook joints and posterior small joints) can cause stimulation and compression of the spinal nerve roots. In addition, the narrowing of the root canal, the adhesive arachnoiditis at the root sleeve, and inflammation and tumors in the surrounding area can also cause symptoms similar to this disease.

First, various kinds of pressure-induced substances directly cause compression, traction and local secondary reactive edema, which are manifested as root symptoms. Second, the sinus nerve endings on the wall of the dural wall through the root sleeve. And showed symptoms of the neck.

Examine

an examination

Related inspection

Neck test

Upper extremity radiation pain or numbness, this pain and numbness radiates along the direction and dominating area of the compressed nerve root, and sometimes the appearance and relief of symptoms are clearly related to the position and posture of the patient's neck;

The upper limb of the affected side feels heavy, the grip strength is reduced, and sometimes the object falls.

1, limb paralysis examination, mainly to check the biceps and triceps tendon reflex. The main nerve that governs the biceps is the neck 6 nerve, and the triceps muscle is the neck 7 nerve. In early lesions, these nerve roots may be stimulated to exhibit sputum reflexes, while damaging lesions may reduce or disappear.

2, imaging examination, X-ray film can show abnormal changes in cervical curvature, vertebral instability and spur formation, MRI examination can clearly show the local pathological anatomy, including the nucleus pulposus protrusion and prolapse, spinal nerve The location and extent of the root involvement.

Diagnosis

Differential diagnosis

Handlessness: The powerlessness of the hand is mainly manifested when there is no power when holding the object. Hand nerve compression syndrome, pre-spinal syndrome, cervical spondylosis, tennis elbow and other diseases can cause hand grip weakness. The nerve compression syndrome is one of the bone-fiber tube and ventricular compression syndrome. For the peripheral nerves, a certain part of the bone fiber tube, a small number of fibrous edges caused by compression and chronic damage caused by inflammatory reactions, resulting in abnormal neurological function.

The hand is unable to unconsciously throw away the object: patients with cervical rib syndrome, the elbow work is easy to fatigue, the hand is weak, unconsciously throwing away the object.

Upper limb weakness: Most of the early amyotrophic lateral sclerosis is upper limb weakness. Amyotrophic lateral sclerosis involves the upper motor neurons (brain, brainstem, spinal cord) and affects the lower motor neurons (cranial nucleus, spinal cord anterior horn cells) and their dominating trunk, limbs and head and face muscles. A chronic progressive degenerative disease. Clinically, it is often characterized by mixed upper and lower motor neurons with impaired mixed sputum.