Elizabeth Worthley recently completed her doctoral studies at A.T. Still University in Mesa, Ariz. The author has disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2022 Dec 1;35(12):28-31. doi: 10.1097/01.JAA.0000885148.23550.32.
Neuropathic upper extremity pain has many causes. Cubital tunnel syndrome is the second most common compressive peripheral neuropathy after carpal tunnel syndrome. Entrapment, or compression, of the ulnar nerve at the elbow classically presents with elbow pain, numbness in the ulnar nerve distribution, and weakness in the hand. C8 radiculopathy and various brachial plexopathies can mimic cubital and carpal tunnel syndromes. Neoplastic brachial plexopathy typically is caused by local extension of a primary or metastatic tumor into the brachial plexus. Double-crush syndrome further complicates neuropathic upper extremity pain. This case report describes a patient with a double-crush lesion involving the ulnar nerve at the elbow and a metastatic mass involving the lower trunk of the brachial plexus. Because of overlapping symptoms and presentations of several upper extremity nerve conditions, clinicians must perform a thorough history and physical examination and understand the sensory and motor innervation of the upper extremity to arrive at a timely and accurate diagnosis.
神经性上肢疼痛有很多原因。肘管综合征是继腕管综合征之后第二常见的压迫性周围神经病。尺神经在肘部受压或卡压，典型表现为肘部疼痛、尺神经分布区麻木和手部无力。C8 神经根病和各种臂丛神经病可模拟肘管和腕管综合征。肿瘤性臂丛神经病通常由原发性或转移性肿瘤局部扩展至臂丛引起。双重挤压综合征进一步加重神经性上肢疼痛。本病例报告描述了一名患者的双重挤压病变，涉及肘部尺神经和涉及臂丛下干的转移性肿块。由于几种上肢神经疾病的症状和表现存在重叠，临床医生必须进行全面的病史和体格检查，并了解上肢的感觉和运动神经支配，以做出及时和准确的诊断。
