Cheiralgia Paresthetica: An Isolated Neuropathy of the Superficial Branch of the Radial Nerve

Objective: “Cheiralgia paresthetica” is the term suggested by Wartenberg in 1932, to define isolated neuropathy of the superficial branch of the radial nerve (SRN). Radial nerve compression can occur throughout its course in the forearm, especially in the tunnel region beneath the tendon of the brachioradialis muscle. The authors report three cases with review of the literatures. Methods: The authors experienced three cases of cheiralgia paresthesia during the last 5 years. The cause of injury was; acupuncture-related injury, a direct, blunt trauma to the SRN, and a cephalic venipuncture-related injury. Results: In two of the three patients, medical treatment was not effective and an exploration with external neurolysis was performed to relieve chronic neuropathic pain of the SRN injury. Medical treatment with neuropathic medication was effective in one patient. Severe adhesions with scar formation around the SRN were found during exploration. The pain and paresthesia improved immediately after operation by about 50% preoperatively and the residual pain and allodynia progressively alleviated in about 3 to 6 months. There were some residual sensory loss and dysesthesia despite of aggressive treatment at the last follow-up at 12 months. Conclusion: Although the injury to the SRN is known to be rare, according to our experiences, it seemed more popular than we thought. An attention and education with anatomic knowledge of the SRN should be paid in cephalic venipuncture or acupuncture treatment.