Treatments of the two different pattern (axonal vs demyelinating) of radial neuropathy: two cases

초록

The entrapment of the radial nerve or its branches is most common within the proximal forearm and at the elbow. Recovery from entrapment may occur quickly over several weeks if the compression is reversible and causes only focal demyelination. In contrast, entrapment causing significant axonal loss, evidenced by marked decrease in motor and sensory amplitudes, will have a longer and less complete recovery. In this study, we report the two cases of radial nerve entrapment(focal demyelination dominant posture-induced radial neuropathy; predominantly axonal type posterior interosseous nerve(PIN) palsy with rheumatic arthritis(RA)) as following reason. First, we identified different clinical course of two type neuropathies. Second, we experienced a good response with less invasive sono-guided steroid injection in patient considering surgery.Conclusion Compressive radial neuropathy has a good prognosis within several weeks in demyelination . But axonopathy, a more severe stage of injury, needed more time to recovery. Surgery is not the only treatment option for managing PIN palsy of severe axonopathy in rheumatoid arthritis. If there is no severe deformity of nerve on imaging evaluation, repeated non-surgical intervention would be warranted.