Ulnar neuropathy at the elbow: Difference between revisions

'''Idiopathic Ulnarulnar neuropathy at the elbow''' (aka Ulnar [[Nerve compression syndrome|nerve entrapment]] or Cubital tunnel syndrome) is a condition where pressure on the [[ulnar nerve]] as it passes through the cubital tunnel causes nerve[[ulnar dysfunction (neuropathy)]]. The symptoms of neuropathy are paresthesia (tingling) and numbness (loss of sensibility) primarily affecting the little finger and ring finger of the hand. Ulnar neuropathy can progress to weakness and atrophy of the muscles in the hand (interossei and small and ring finger lumbricals). Symptoms can be alleviated by attemptsthe use of a splint to keepprevent the elbow from flexing while sleeping, such as sticking one's arm in the pillow case, so the pillow restricts flexion.

The specific symptoms experienced in the characteristic distribution depend on the specific location of ulnar nerve compression. The hallmark symptoms of ulnar neuropathy at the elbow (cubital tunnel syndrome) is paresthesia (tingling). This can progress to a loss of sensibility. Muscle weakness is usually experienced as a loss of dexterity.

[[Ulnar neuropathytunnel syndrome]] ([[ulnar neuropathy|ulnar neuropathy at the wrist]]) is associated with variable symptoms, as the ulnar nerve separates near the hand into distinct motor and sensory branches.

In [[cubital tunnel syndrome]] (ulnar neuropathy at the elbow), sensory and motor symptoms tend to occur in a certain sequence. Initially, there may be intermittent paresthesia and loss of sensibility of the small and ulnar half of the ring fingers. Next is constant numbness (loss of sensibility). The final stage is intrinsic hand muscle atrophy and weakness.

In contrast, when ulnar neuropathy occurs at the wrist (Guyonulnar canaltunnel syndrome), motor symptoms predominate. There may be an ulnar claw hand from imbalance between the muscles innervated by the ulnar nerve in the forearm (which are functioning normally) and those in the hand (which are weak). The back of the hand will have normal sensation.<ref name="pmid11299442">{{cite journal |last1=Aguiar |first1=Paulo Henrique |last2=Bor-Seng-Shu |first2=Edson |last3=Gomes-Pinto |first3=Fernando |last4=Almeida- Leme |first4=Ricardo Jose de |last5=Freitas |first5=Alexandre Bruno R. |last6=Martins |first6=Roberto S. |last7=Nakagawa |first7=Edison S. |last8=Tedesco-Marchese |first8=Antonio J. |title=Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases |journal=Arquivos de Neuro-Psiquiatria |date=March 2001 |volume=59 |issue=1 |pages=106–111 |doi=10.1590/S0004-282X2001000100022 |pmid=11299442 |doi-access=free }}</ref>

===Cubital tunnel syndromePathoanatomy===

The most common location of ulnar nerve impingementcompression at the elbow is within the [[cubital tunnel]],. The symptoms and issigns associated with this pathophysiology are known as '''[[cubital tunnel syndrome''']].<ref name="pmid33115358">{{Cite journal |last1=Thakker |first1=Arjuna |last2=Gupta |first2=Vinay Kumar |last3=Gupta |first3=Keshav Kumar |date=December 2020 |title=The Anatomy, Presentation and Management Options of Cubital Tunnel Syndrome |url=https://pubmed.ncbi.nlm.nih.gov/33115358 |journal=The Journal of Hand Surgery Asian-Pacific Volume |volume=25 |issue=4 |pages=393–401 |doi=10.1142/S2424835520400032 |issn=2424-8363 |pmid=33115358|s2cid=226051048 }}</ref><ref name="pmid17267675" /> The tunnel is formed by the [[medial epicondyle of the humerus]], the [[olecranon]] process of the ulna and the tendinous arch joining the humeral and ulnar heads of the [[flexor carpi ulnaris]] muscle (the cubital tunnel retinaculum; aka Osborne ligament).<ref name="Moore-2010">{{cite book|last=Moore|first=Keith L.|title=Clinically Oriented Anatomy 6th Ed.|year=2010|publisher=Lippincott, Williams and Wilkins|location=Baltimore, MD|isbn=978-07817-7525-0|page=770}}</ref> While most cases of injury are minor and resolve spontaneously with time, chronic compression or repetitive trauma may cause more persistent problems. Commonly cited scenarios include:

* [[Cervical Vertebraevertebrae]]