Cyclist’s Palsy: A Case Report of Acute Ulnar Neuropathy at the Wrist

نویسندگان

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2 MGM Medical College, Kamothe, Navimumbai, India

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doi
10.22037/icnj.v11i1.46898
چکیده

Ulnar neuropathy at the wrist is uncommon and can be caused by various extrinsic and intrinsic factors. Prolonged pressure on a bicycle handlebar can cause symptoms of distal ulnar palsy, known as cyclist's palsy. It can present with purely sensory, purely motor, or combined sensorimotor symptoms and is a challenging clinical diagnosis. Our patient presented with acute right-hand grip weakness and tingling in both hands after a bike ride. A prompt and detailed nerve conduction study (NCS) and needle electromyography (EMG) diagnosed right ulnar neuropathy in Guyon's canal, affecting only its deep motor branch, distal to the hypothenar branch. Stimulation in the palm showed a conduction block in these fibres, thus establishing a neuropraxic neuropathy. In addition, there was evidence of bilateral Carpal Tunnel Syndrome. The patient recovered completely with conservative management. This case illustrates the use of NCS/EMG to diagnose an uncommon neuropathy, resulting in optimal patient outcomes.