Radial nerve

Use the deltoid area only if well developed, and then only with caution to avoid radial nerve injury. Do not inject into the lower and mid-third of the upper arm. 

Sensorimotor deficits imitating peripheral nerve involvement were reported (Back and Mrowka 2001). Ulnar and median nerve-like deficit were due to infarcts located in the thalamus and the corona radiate (Lampl et al. 1995). We have seen two patients with radial nerve-like deficits due to cortical ischemic lesions of the cortical presentation of the hand in the motor cortex. Normal nerve conduction velocity and MRI help to clarify these cases. 

Physical examination found him to be moderately built and nourished. Both hands showed diminished power of the flexors and the extensors to 2/5 on the right and 3/5 on the left.Wasting of the small muscles of the thenar eminence was also noted in both hands. Reflexes of the bra-chioradialis, biceps, and triceps were diminished to 1/4 in the right and 2/4 in the left arm. There was loss of pain and temperature sensation over the distribution of median and radial nerves. All other muscle groups and sensations were normal. Cranial nerves were normal. Abdominal palpation revealed hepatosplenomegaly, which was subsequently confirmed by ultrasound. Oral examination found yellowish plaques on the posterior pharyngeal wall. Eyes, ears, and nose were normal. 

Differential diagnoses of peripheral neuropathy were entertained. Laboratory tests revealed that serum parameters for electrolytes and proteins were all within the normal range. Urine porphyrinogen and porphobilinogen levels were normal. Tests were negative for serum rheumatoid factor and antinuclear antibodies, the latter used in detection of connective tissue diseases such as systemic lupus erythematosus and polyarteritis nodosa that could present with features of peripheral neuropathy. Nerve conduction studies of the radial, ulnar, and median nerves revealed delayed conduction. Biopsies of the ulnar and radial nerves showed loss of nerve fibers and sudanophilic (indicating lipid) deposits in the Schwann cells of the neurons. Similarly, the yellowish plaques of the pharynx showed abundant macrophages filled with sudanophilic material. These deposits were not membrane-bound. 

Three cases of radial nerve palsy were reported in demented elderly patients confined to wheelchairs who were treated with haloperidol. The combination of extrapyra-midal and sedative adverse effects, added to wheelchair confinement, may have resulted in pressure on the upper arm with subsequent neuropathy (18). 

Sloane PD, McLeod MM. Radial nerve palsy in nursing home patients association with immobility and haloperidol. J Am Geriatr Soc 1987 35(5) 465-6. 

Three cases of radial nerve palsy were reported in demented elderly patients confined to wheelchairs who were treated with haloperidol. The combination of... 

Hemorrhagic pulmonary edema Microcytic hypochromic anemia Radial nerve palsy... 

SALMFamide peptides, a family of neuropeptides isolated from species belonging to the phylum Echinodermata. SALMFamide-1 (SI) H-Gly-Phe-Asn-Ser-Ala-Leu-Met-Phe-NHz and SALMFamide-2 (S2)SGPYSFNSGL TFaarethefirstmem-bers of this family found in the radial nerve cords of the starfish (class Aster-oidea). SI and S2 are present in the in-... 

Li Z, Qin H, Feng Z, Liu W, et al. Human umbilical cord mesenchymal stem cell-loaded amniotic membrane for the repair of radial nerve injury. Neural Regen Res December 25, 2013 8(36) 3441-8. 

The radial nerve is closely applied to the humeral shaft in its middle and distal thirds. If, following manipulation of mid to lower third displaced fractures, a radial nerve palsy develops in association with soft tissue interposition on radiographs, sur-... 

Fig. 9.14. Fractures at the junction of the mid and distal third of the humerus can unite in a varus position which is not cosmetically acceptable. The radial nerve is also in close proximity at this level and its function must be carefully assessed in such cases...

Extensor group Supplied by the radial nerve, this group is made up of the triceps and the anconeus. 

Monteggia injuries occur most frequently between the ages of 5 and 7. Patients will generally complain of forearm and elbow pain. If the ulna is fractured, pain will be maximal in the arm and there may be swelling and deformity. The elbow will also be swollen. In 10%-20% of cases, a neuropraxia of the radial nerve will be present, particularly if the radial head is dislocated laterally or anteriorly. Most of these nerve injuries will recover within 6-9 weeks and intervention is not indicated unless there is no sign of clinical or electromyographic recovery at 6 months. 

Peripheral neuropathy wrist drop, due to radial nerve involvement, is a classic manifestation of chronic lead neurotoxicity. Clinical and experimental studies support the view that lead induces peripheral nerve lesions. Central nervous system the manifestations of saturnine encephalopathy include headache, irritability, insomnia, apprehension, confusion, nightmares and fits. High exposure levels (at least 200/ig Pb/lOOml in children and 500)Ltg Pb/lOOml in adults) are usually found. Recovery from encephalopathy is often incomplete, and residual neurological damage is frequent. 

Radial nerve dorsum of web space between thumb and index finger... 

In a case report, a 52-year-old man with psoriasis and relapsing-remitting MS developed an injection site cutaneous necrosis that involved both subcutaneous and muscular tissue with massive oedema 21 months after GA treatment. Three days later he developed radial nerve palsy. After a few days another similar lesion appeared at another injection site [26 ]. 

Carotenuto A, lodice R, Barbato F, Orefice NS, Orefice G. Necrotizing skin lesion and radial nerve palsy in a patient treated with glatiramer acetate. J Neurol Sci August 15, 2013 331(l-2) 172-3. PubMed PMID 23778027. Epub 2013/06/20. eng. 

Fig. 4.20a-c. Cystic schwannoma. a,b Long-axis a gray-scale and b color Doppler 12-5 MHz US images over the radial nerve (arrowheads) at the arm with c MR-neurographic correlation show a rounded mass (arrows) with intratumoral cystic changes, related to accumulation of myxoid matrix, in continuity with the parent nerve (arrowheads). The tumor exhibits a hypervascular pattern made up of peripheral and central color Doppler signals... 

Bodner G, Huber B, Schwabegger A, Lutz M et al (1999) Sonographic detection of radial nerve entrapment within a... 

Proceeding toward the interscalene area, the roots of C5 and C6 join together to form the upper trunk, the root of C7 emerges by itself as the intermediate trunk and, in the lower neck, the roots of C8 and Tl form the lower trunk of the plexus. More distally, in the supraclavicular region, each trunk gives off two divisional branches, named the anterior and posterior divisions, which innervate the flexor and extensor muscles of the upper extremity respectively. In the axilla, these divisions join in various combinations to form the cords of the brachial plexus. The relationship of the cords with the axillary artery determines their names the lateral, medial and posterior cords. The axillary and radial nerves originate from the posterior cord, the musculocutaneous and part of the median nerve arise from the lateral cord, vdiereas the other contribution of fibers to the median nerve and the ulnar nerve originate from the medial cord. 

The radial nerve originates from the posterior cord of the brachial plexus (C5-C8) and supplies the... 

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