Proximal median neuropathy and cervical radiculopathy: double crush revisited

"Double crush" refers to the hypothesis that a single lesion along the course of a nerve predisposes that nerve to a second lesion further along its course. The reason for this is uncertain and indeed the existence of the double crush syndrome is itself debated. We present two cases of proximal median neuropathy (PMN) associated with cervical radiculopathy which we diagnosed in our EMG laboratory over a short period of time. Seeing these cases in relative rapid succession and considering the extreme rarity of PMN, its association in both cases with cervical root disease supports the notion that the cervical radiculopathy may have predisposed the nerve to a second lesion along its course, resulting in the so called double crush syndrome, and that this syndrome may therefore be a true entity.