ISOLATED PERIPHERAL NERVE NEUROPATHY ASSOCIATED WIHT A SINGLE TRAVMA: REPORT OF TWO CASES

Yıl 2018, Cilt: 19 Sayı: 4, 145 - 148, 26.10.2018

Çetin Kürşad Akpınar Murat Çalık Emrah Aytaç

https://doi.org/10.18229/kocatepetip.475006

Öz

The musculocutaneous nerve arises from the

lateral cord of the brachial plexus. It innervates

muscles such as the biceps brachi and

brachialis. Ulnar nerve is the major terminal

branche of brachial Plexus. The deep motor

branch of the ulnar nerve is a terminal primarily

motor branch of the ulnar nerve. At its origin it

innervates the hypothenar muscles. Nerve

injury due to isolated trauma is rarely seen.

Musculocutaneous and deep ulnar motor

branch neuropathy can be caused by repetitive

trauma. We present report of two cases of (65

year old female and 40 year old male) isolated

nerve injury who complaine of atrophy painless

and weakness. Electrophysiological testing

revealed a musculocutaneous and deep ulnar

nerve neuropathy. Magnetic resonance imaging

and electrodiagnostic studies may be useful in

differentiating between these conditions. In the

literature, there are very few cases in which

ısolated lesions of the musculocutaneous and

deep ulnar motor nerves lesion have been

attributed to a single trauma.

Anahtar Kelimeler

Musculocutaneous nerve, Deep motor branch ulnar nerve, Neuropathy, Isolated nerve injury

TEK BİR TRAVMAYA BAĞLI GELİŞEN İZOLE PERİFERİK SİNİR NÖROPATISI: İKİ OLGU SUNUMU

Öz

Muskulokutanöz sinir brakiyal pleksus lateral

kordundan ayrılır. Biceps braki ve brakiyalis gibi

kasları innerve eder. Ulnar sinir ise brakiyal pleksusun

major terminal dalıdır. Ulnar sinirin terminal

dalı derin ulnar motor daldır. Hipotenar

kasları innerve eder. İzole travmatik sinir hasarı

oldukça nadir görülmektedir. İzole travma nedeniyle

sinir hasarı gelişmesi nadir bir durumdur.

Biz bu yazıda atrofi ve ağrısız güçsüzlük yakınmasıyla

başvuran iki izole sinir hasarı olgusu

(65 yaşında kadın ve 40 yaşında erkek) sunduk.

Olgularımızdaki muskulokutanöz ve derin ulnar

motor dal nöropatisinin tek bir travmadan kaynaklandığını

düşünmekteyiz. Yapılan elektrodiagnostik

testler, izole muskulokutanöz ve derin

ulnar motor sinir nöropatisini göstermiştir.

Manyetik rezonans görüntüleme ve elektrofizyolojik

çalışmalar bu hastalıkların ayırıcı tanısında

faydalıdır. Literatürde izole muskulokutanöz

ve derin ulnar motor sinir hasarının, tek bir travma

nedeniyle oluştuğunu bildiren çok az sayıda

olgu sunumu vardır.

Anahtar Kelimeler

Muskulokutanöz sinir, Ulnar sinir derin motor dalı, Nöropati, İzole sinir hasarı

Kaynakça

• 1. Stockert BW. Peripheral Neuropathies (In) Umphred DA (Ed) Neurological Rehabilitation. 3st ed. St Louis. Mosby-Year Book, 1995;360-374.
• 2. Stillwell GK, Thorsteinsson G. Rehabilitation Procedures (In) Dyck PJ, Thomas PK (Eds) Peripheral Neuropathy. 3st ed. Philadelphia. WB Saunders Comp, 1993;1692-1708.
• 3. Giugale JM, Henrikson KJ, Baronne LM, Lee JY. Traumatic brachial plexus root avulsion and cervical spine epidural hematoma in an 18-year-old man. Spine J 2015;15:365-366.
• 4. Fabre T, Piton C, Andre D, Lasseur E, Durandeau A. Peroneal nerve entrapment. J Bone Joint Surg Am 1998;80:47-53.
• 5. Seror P. Ulnar nerve lesion at the wrist and sport: A report of 8 cases compared with 45 non-sport cases. Ann Phys Rehabil Med 2015;58:104-109.
• 6. Juel VC, Kiely JM, Leone KV, Morgan RF, Smith T, Phillips LH. Isolated musculocutaneous neuropathy caused by a proximal humeral exostosis. J Child Neurol 2011;26:1567-1570.
• 7. Murata K, Shih JT, Tsai M. Causes of ulnar tunnel syndrome: a retros- pective study of 31 subjects. J Hand Surg Am 2003;28:647-651.
• 8. Henry D, Bonthius DJ. Isolated musculocutaneous neuropathy in an adolescent baseball pitcher. Neurology 2000;54:494-496.
• 9. Swain R. Musculocutaneous nerve entrapment: a case report. Clin J Sport Med 1995;5:196-198.
• 10. Pećina M, Bojanić I. Musculocutaneous nerve entrapment in the upper arm. Int Orthop 1993;17:232-234.
• 11. Mastaglia FL. Musculocutaneous neuropathy after strenuous physical activity. Med J Aust 1986;145:153-154.
• 12. Wang B, Zhao Y, Lu A, Chen C. Ulnar nerve deep branch compression by a ganglion: a review of nine cases. Injury 2014;45:1126-1130. 148