Dimitrios Tsiptsios1, Anastasios Anastasiadis2, Andreas Ouranidis3, Andreas S Triantafyllis4, Petros Fountoulakis4, Michael Spartalis5, Dimitrios Tsartsalis6, Konstantinos Tsamakis7. 1. Neurophysiology Department, Sunderland Royal Hospital, South Tyneside & Sunderland NHS Foundation Trust, Sunderland, United Kingdom. 2. First Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece. 3. Department of Pharmaceutics, Aristotle University of Thessaloniki, Thessaloniki, Greece. 4. Cardiology Department, Asklepeion General Hospital, Athens, Greece. 5. Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece. 6. Emergency Department, Hippokration General Hospital, Athens, Greece. 7. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
Abstract
Introduction:Ambulatory blood pressure monitoring (ABPM) is a non-invasive method of obtaining brachial artery pressure assessment over 24 hours while patients undergo normal daily activities. Side effects, such as peripheral petechiae, limb edema, and sleep disturbance, are usually mild and reversible. Case report:A 67-year-old male presented with excruciating left hand pain and weakness on waking up from night sleep, having worn a cuff on his left arm for a whole day in the context of 24-hour ABPM. Clinical extremeexamination confirmed hypoesthesia in the left median and ulnar nerve distribution and weakness solely affecting ulnar and sparing median innervated hand muscles. Neurophysiological testing was performed. Interestingly, although median and ulnar motor responses were abnormal the respective sensory responses were unremarkable. Conclusion: To our knowledge, this is the first reported case of simultaneous proximal median and ulnar neuropathy complicating 24-hour ABPM. From a neurophysiological standpoint, it is also intriguing as this is a rare case of peripheral neuropathy with prominent motor fibre involvement, but normal sensory responses.
Introduction:Ambulatory blood pressure monitoring (ABPM) is a non-invasive method of obtaining brachial artery pressure assessment over 24 hours while patients undergo normal daily activities. Side effects, such as peripheral petechiae, limb edema, and sleep disturbance, are usually mild and reversible. Case report:A 67-year-old male presented with excruciating left hand pain and weakness on waking up from night sleep, having worn a cuff on his left arm for a whole day in the context of 24-hour ABPM. Clinical extremeexamination confirmed hypoesthesia in the left median and ulnar nerve distribution and weakness solely affecting ulnar and sparing median innervated hand muscles. Neurophysiological testing was performed. Interestingly, although median and ulnar motor responses were abnormal the respective sensory responses were unremarkable. Conclusion: To our knowledge, this is the first reported case of simultaneous proximal median and ulnar neuropathy complicating 24-hour ABPM. From a neurophysiological standpoint, it is also intriguing as this is a rare case of peripheral neuropathy with prominent motor fibre involvement, but normal sensory responses.
Authors: Peter Marschang; Andreas Niederwanger; Rudolf W Gasser; Martin Daniaux; Wolfgang Sturm Journal: Thromb Haemost Date: 2008-10 Impact factor: 5.249
Authors: Marnie B Welch; Chad M Brummett; Terrence D Welch; Kevin K Tremper; Amy M Shanks; Pankaj Guglani; George A Mashour Journal: Anesthesiology Date: 2009-09 Impact factor: 7.892