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Ulnar tunnel syndrome
contents
- definition
- Symptoms and causes
- diagnosis
- treatment
definition
The Loge-de-Guyon syndrome describes a nerve compression of the nerve on the small finger side, the ulnar nerve. It passes at the wrist between two carpal bones - the pea and the hook leg (Os pisiforme and Os hamatum). This bottleneck is named after its discoverer as "Loge de Guyon". There, the nerve can be easily disconnected, causing disturbances of the sensation and sometimes even paralysis phenomena. The clinical picture is defined in this case as "Loge-de-Guyon syndrome". For the first time described the symptoms of the French urologist and surgeon Jean Casimir Felix Guyon (1831-1920).
The Loge de Guyon syndrome was named after its discoverer the French urologist and surgeon Jean Casimir Felix Guyon. (Image credits: sokaeiko / pixelio.de) Symptoms and causes
Affected initially complain usually a slight tingling sensation or numbness in the little finger and possibly the ring finger. It is often associated with acute wrist strain such as prolonged cycling or motorcycling, but other triggers such as an overbone, a ganglion cyst, a thrombosis, or a tumor may be behind the discomfort. If the compression of the nerve lasts for a long time, it is often possible to observe a atrophy of the muscles and thus a narrowing of the tissue relief on the little finger side. In more pronounced forms, the impairments range to paralysis in the fingers and the hand.
Often, discomfort and muscle weakness in the little finger are first indications of the Loge-de-Guyon syndrome. (Image: black_jik / fotolia.com) diagnosis
If there is a suspicion of a Loge-de-Guyon syndrome in view of the symptoms, the nerve conduction velocity is first measured on the ulnar nerve or on its branches (Ramus superficialis, Ramus profundus). If there are any delays in the course of an electroneurography, this is considered evidence of damage to the nerve. With the help of a so-called MR-neurography (special magnetic resonance tomography), as it is offered for example at the University Hospital Heidelberg, the cause of the complaints can be further limited. According to the University Hospital, MR neurography "also allows accurate visualization of fine nerve branches on the hand" so that "the various forms of the Loge-de-Guyon syndrome and the exact damage sites of different nerve branches" can be determined.
It should be noted at the diagnosis that there is another constriction of the ulnar nerve at the elbow, where the nerve runs in a groove and can also be easily squeezed. There are also three constrictions on the neck, under the clavicle and the small pectoralis muscle. If no compression of the nerve can be detected in the lodge-de-guyon, the cause of the complaints may therefore be to be found here. It makes sense to consider these bottlenecks in each case and to determine whether there are problems here which possibly contribute to the maintenance of the Loge de Guyon syndrome and thus can be therapeutically relevant.
The ulnar nerve can also be pinched at other bottlenecks in its course, resulting in similar complaints as in the Loge-de-Guyon syndrome. (Image: bilderzwerg / fotolia.com) treatment
The treatment of the Loge-de-Guyon syndrome is basically based on the detected triggers. For example, with a Gangliom (Überbein), a Ganglienzyste or a tumor no way past a surgical procedure. However, if the cause is an acute overload, immobilization and protection of the wrist can usually achieve a complete resolution of the symptoms. (tf, fp, last updated on 03.01.2017)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)