Spontaneous radial nerve palsy with hourglass-like constriction

Area of Science:

• Neurology
• Surgical Neurology

Background:

• Hourglass-like constriction (HLC) is an uncommon mononeuropathy.
• It typically affects radial and median nerve branches, causing pain and palsy.
• HLC specifically of the radial nerve (RN) is exceptionally rare.

Observation:

• A case of acute wrist and finger drop due to HLC of the RN is presented.
• The patient underwent clinical observation for 5 months.
• Surgical resection and primary repair were performed.

Findings:

• The patient experienced a satisfactory recovery following surgical intervention.
• Conservative treatment for 3-7 months is generally recommended for HLC.
• Primary repair techniques like neurorrhaphy or nerve grafts show better outcomes for RN constrictions.

Implications:

• This case adds to the limited understanding of HLC in the radial nerve.
• It highlights the potential benefits of surgical intervention for refractory RN HLC.
• Further research is needed to elucidate the pathophysiology and optimal management of RN HLC.