Cheiralgia paresthetica

Under the Wartenberg syndrome, also called Cheiralgia paresthetica, refers to a nerve compression syndrome with numbness of the stretch side ( dorso- ulnar ) thumb side, the extensor side of the index finger area as well as in the first Intermetacarpalraum. Named is the Wartenberg syndrome after Robert Wartenberg, who described it in the 30s of the 20th century for the first time.

Cause

The most common cause of Wartenberg 's syndrome is a compression injury to the sensitive components ( superficial branch ) of the radial nerve. Cause of pressure damage can be for example to close watch bands, bracelets, casts or handcuffs (also the further designation of the syndrome as a convict palsy or paralysis hence bondage ). In case series showed that a proportion of cases associated with diabetes mellitus. In another part of the cases a strong stress on the wrist at work could be found. Also, local trauma to the thumb- side edge of the lower forearm as they come under impact or cuts materialize, can lead to damage of the nerve.

Diagnosis

Indicative of the diagnosis are the clinical symptoms already described. Tinel sign positive. The Finkelstein test can be positive, but is not pathognomonic for this disease. The electroneurography shows signs of damage to the superficial, it also serves the differential diagnosis of carpal tunnel syndrome or further damage to the radial nerve excluded.

If the complaints of Wartenberg 's syndrome be limited to pain and no dysesthesias that are similar to symptoms of tenosynovitis stenosing de Quervain or intersection syndrome, which must also be included in the considerations in the differential diagnosis.

Therapy

Primary, a conservative therapy with short-term immobilization on the dorsal forearm splint, the use of NSAIDs and steroid injections are local attempts.