The Study Of The Pathogenesis Of Spontaneous Radial Nerve Palsy

Background:Most of the peripheral nerve paralytic disease cause by the traumatic or press-fitting damage, while few of them can also caused by inflammatory or metabolic lesions. But there are a few cases appear nerve palsy and function obstacle without definite injury history. The paralysis nerves were found significant narrow in surgery, but external press-fitting structure cannot be found. We call it spontaneous peripheral nerve palsy whose cause is not clear now. As deepening research of peripheral nerve disease, new ideas and hypothesis are constantly being proposed, such as press-fitting theory, joint repetitive movements theory, nerve bundle reverse shift theory, inflammation, ect. These theories are put forward and are used to illustrate the cause and pathogenesis of the spontaneous radial nerve paralytic. In 2010, Gu Yu-dong academician put forward that the disease may belongs to a class oppression predisposition hereditary neuropathies in essence which indicated the new direction for the etiology of the spontaneous paralysis research. The name, diagnosis and treatment of the disease are more complex because of unknown etiology. Therefore the etiology and pathogenesis of spontaneous are the field that most scholars concern. It is an important way to improve the diagnostic level of the disease.It is very important to the development of surrounding neurology.Objective:To summarize current clinical material and improve the understanding of such diseases.To comprehensive discuss the etiology and pathogenesis existing and put forward a new theory about the etiology of spontaneous radial nerve paralysis.Methods:Collect 28 patients with spontaneous radial nerve paralysis who have accepted the operation from 2001 to 2010 in the First Affiliated Hospital of Jilin University. Summarize the clinical features of spontaneous radial nerve paralysis through the analysis of clinical data.Put forward a new view about the etiology of spontaneous radial nerve paralysis through the recent research.Results:Put forward clinical features of spontaneous radial nerve paralysis based on the analysis of the clinical data:(1)The spontaneous radial nerve paralysis is different from the radial nerve paralysis of trauma or press-fitting. There are no clear incentives. A few patients have history of pull compression or fever. (2) The spontaneous radial nerve paralysis often occurs in the range of upper arm lateral muscle intervals and forearm Frohse bow which is around elbow. (3)It often appear single nerve with several lesions or bilateral radial nerve with lesions. (4) The spontaneous radial nerve paralysis often appear motorneuron involved and sensory nerve normal.Conclusion:We put forward new views about etiology and pathogenesis based on the clinical characteristics of the spontaneous radial nerve paralysis: (1)The pathogenesis of the spontaneous radial nerve paralysis relate with variety of pathogenic factors. (2) Motor nerve predisposition relate with the differences of space arrangement between sports nerve bundle and sensory nerve bundle in the trunk of mix the radial nerve. (3)Motor nerve predisposition of the spontaneous radial nerve paralysis may relate with virus infection.