Guyon's Tunnel Syndrome During Pregnancy with Concomitant Anomalous Arch of the Ulnar Nerve: a Case Report
Abstract
Numerous causes are reported for ulnar nerve compression at the wrist, known as Guyon's tunnel syndrome. In the present article, a patient with Guyon's tunnel syndrome during pregnancy concomitant with an anomaly of ulnar nerve is described. A 29-year-old Iranian woman presented with clinical features of Guyon's tunnel syndrome (pain and paresthesia in the fifth finger of the left hand and atrophy of the first dorsal interosseus muscle). Symptoms of the patient appeared during the third trimester of pregnancy. Electro diagnostic studies confirmed Guyon's tunnel syndrome. Surgical exploration revealed an anomalous arch of the ulnar nerve passing through the flexor carpi ulnaris (FCU) tendon. The anomalous arch of the ulnar nerve was released by resection of the segment of FCU tendon passing through the ulnar nerve arch. Therefore, in patients with Guyon's tunnel syndrome, the ulnar nerve anomaly should be kept in mind as a cause. Moreover, pregnancy may have a provocative effect on Guyon's tunnel syndrome similar to carpal tunnel syndrome (CTS).
Georgiev GP, Jelev L, Surchev L. Undescribed variant muscle--"deep abductor-flexor" of the little finger, in relation to ulnar nerve compression at the wrist. Ann Anat 2007;189(3):276-82.
Kwak KW, Kim MS, Chang CH, et al. Ulnar Nerve Compression in Guyon's Canal by Ganglion Cyst. J Korean Neurosurg Soc 2011;49(2):139-41.
Chan JC, Tiong WH, Hennessy MJ, et al. A Guyon's canal ganglion presenting as occupational overuse syndrome: Acase report. J Brachial Plex Peripher Nerve Int 2008;3(1):4.
Vance RM, Gelberman RH. Acute ulnar neuropathy with fractures at the wrist. J Bone Joint Surg Am 1978;60(7):962-5.
Gore DR. Carpometacarpal dislocation producing compression of the deep branch of ulnar nerve. J Bone Joint Surg Am 1971;53(7):1387-90.
Lal RA, Raj S. Guyons canal syndrome due to accessory palmaris longus muscle: aetiological classification: a case report. Cases J 2009;2(1):9146.
Kim SS, Kim JH, Kang HI, et al. Ulnar nerve compression at Guyon's canal by an arteriovenous malformation. J Korean Neurosurg Soc 2009;45(1):57-9.
Ozdemir O, Calisaneller T, Altinors N. Compression of the ulnar nerve in Guyon's canal by an arteriovenous malformation. J Hand Surg Eur 2007;32:600-1.
Taylor AR. Ulnar nerve compression at the wrist in rheumatoid arthritis. Report of a case. J Bone Joint Surg Br 1974;56(1):142-3.
Sakai K, Tsutsui T, Aoi M, et al. Ulnar neuropathy caused by a lipoma in Guyon's canal--case report. Neurol Med Chir (Tokyo) 2000;40(6):335-8.
O'Hara JJ, Stone JH. Ulnar neuropathy at the wrist associated with aberrant flexor carpi ulnaris insertion. J Hand Surg Am 1988;13(3):370-2.
Harrelson JM, Newman M. Hypertrophy of the flexor carpi ulnaris as a cause of ulnar-nerve compression in the distal part of the forearm. Case report. J Bone Joint Surg Am 1975;57(4):554-5.
Zook EG, Kucan JO, Guy RJ. Palmar wrist pain caused by ulnar nerve entrapment in the flexor carpi ulnaris tendon. J Hand Surg Am 1988;13(5):732-5.
Kang HJ, Yoo JH, Kang ES. Ulnar nerve compression syndrome due to an anomalous arch of the ulnar nerve piercing the flexor carpi ulnaris: a case report. J Hand Surg Am 1996;21(2):277-8.
Carpal tunnel syndrome. Absolute Astronomy. (Accessed in Jan 17, 2014, at www. absoluteastronomy.com/topics/Carpal tunnel syndrome)
Ablove RH, Ablove TS. Prevalence of carpal tunnel syndrome in pregnant women. WMJ 2009;108(4):194-6.
Jurjević A, Bralić M, Antoncić I, et al. Early onset of carpal tunnel syndrome during pregnancy: case report. Acta Clin Croat 2010;49(1):77-80.
Khosrawi S, Maghrouri R.The prevalence and severity of carpal tunnel syndrome during pregnancy. Adv Biomed Res. 2012;1(1):43.
Rozali ZI, Noorman FM, De Cruz PK, et al. Impact of carpal tunnel syndrome on the expectant woman's life. Asia Pac Fam Med 2012;11(1):1.
McLennan HG, Oats JN, Walstab JE. Survey of hand symptoms in pregnancy. Med J Aust 1987;147(11- 12):542-4.
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| Issue | Vol 52, No 7 (2014) | |
| Section | Original Article(s) | |
| Keywords | ||
| Guyon's Tunnel Syndrome Ulnar Nerve Anomaly Wrist Pregnancy | ||
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