Cheiralgia parestheticacheiralgia paresthetica, cheiralgia paresthetica treatment
Cheiralgia paraesthetica Wartenberg's syndrome is a neuropathy of the hand generally caused by compression or trauma to the superficial branch of the radial nerve1 The area affected is typically on the back or side of the hand at the base of the thumb, near the anatomical snuffbox, but may extend up the back of the thumb and index finger and across the back of the hand12 Symptoms include numbness, tingling, burning or pain Since the nerve branch is sensory there is no motor impairment2 It may be distinguished from de Quervain syndrome because it is not dependent on motion of the hand or fingers3
The most common cause is thought to be constriction of the wrist, as with a bracelet or watchband hence reference to "wristwatch neuropathy" It is especially associated with the use of handcuffs and is therefore commonly referred to as handcuff neuropathy Other injuries or surgery in the wrist area can also lead to symptoms, including surgery for other syndromes such as de Quervain's4 The exact etiology is unknown, as it is unclear whether direct pressure by the constricting item is alone responsible, or whether edema associated with the constriction also contributes2
Symptoms commonly resolve on their own within several months when the constriction is removed; NSAIDs are commonly prescribed3 In some cases surgical decompression is required3 The efficacy of cortisone and laser treatment is disputed3 Permanent damage is possible
This neuropathy was first identified by Robert Wartenberg in a 1932 paper5 Recent studies have focused on handcuff injuries due to the legal liability implications, but these have been hampered by difficulties in followup, particularly as large percentages of the study participants have been inebriated when they were injured6 Diagnostically it is often subsumed into compression neuropathy of the radial nerve as a whole eg ICD-9 3543, but studies and papers continue to use the older term to distinguish it from more extensive neuropathies originating in the forearm
- Radial neuropathy
- ^ a b Buttaravoli, Philip M; Stair, Thomas O "920 Cheiralgia Paresthetica Handcuff Neuropathy" Common Simple Emergencies Washington: Longwood Information
- ^ a b c Pećina, Marko; Krmpotić-Nemanić, Jelena; Markiewitz, Andrew D 2001 "Chapter 26: Syndrome of the Superficial Branch of the Radial Nerve" Tunnel syndromes: peripheral nerve compression syndromes CRC Press pp 152–155
- ^ a b c d Dang, Alan C; Rodner, Craig M December 2009 "Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve" PDF Journal of Hand Surgery 34A: 1912–1914 doi:101016/jjhsa200910016
- ^ Chodoroff, G; Honet, J C Sep 1985 "Cheiralgia paresthetica and linear atrophy as a complication of local steroid injection" Archives of Physical Medicine and Rehabilitation 66 9: 637–639 PMID 4038032
- ^ Braidwood, A S 1975 "Superficial Radial Neuropathy" Journal of Bone and Joint Surgery 57–B 3: 380–383 Archived from the original on 2011-07-24
- ^ Grant, Arthur C; Cook, Albert A 2000 "A Prospective Study of Handcuff Neuropathies" PDF Muscle and Nerve 23: 933–938 Archived from the original PDF on 2011-07-08
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