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Old 09-24-2018, 05:31 PM
EKOne EKOne is offline
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Join Date: Sep 2018
Posts: 6
5 yr Member
EKOne EKOne is offline
Junior Member
 
Join Date: Sep 2018
Posts: 6
5 yr Member
Default Spontaneous cutaneous nerve injury?

Hello, I am having some symptoms that I can't explain, I would love some advice, or to know if anyone had a similar experience. Sorry for the long text, I just really not sure what I have so I don't want to miss any symptom from my story.

I am 25 years old. I don't have any background health issue. So starting two months ago, my thumb flexor is almost fully paralyzed. Incomplete AIN syndrome is suspected (or maybe some muscle injury that didn't show up on MRI). Anyway, even if it is a nerve compression, it was probably triggered by an injury in the gym (I didn't feel anything during the training, but the pain, which was not muscle injury pain, but some 'internal' serve pain along the whole forearm, from the wrist to the elbow, started one/two days later. I was in a lot of pain for a week, and ain nerve is motor only never and shouldn't cause pain)

But my question is not about that nerve. Three week later I had an EMG. sadly they didn't test the right muscle (but it did found out that I have some axonal neuropathy of the ulnaris at the elbow level with signs of active denervation of one muscle, but it is pretty much symptoms less and that muscle has ok strength so I am not worried about it right now) . But two days after that EMG I started to have symptoms of new nerve pain. On movement (for example when extending my arm), I got some serve sharp or burning or electric pain in my forearm, just above the wrist. Quickly I found out that there is an area in the upper part of my forearm, that if I tap on it I feel an electric shock traveling down my forearm (and the pain is really along that line). Today I know that it is called Tinel sign. But I don't have tingling sensation on the skin, I just sensation of the nerve in the distal area.

Anyway, the symptoms got better over the following week and half (less frequently, less painful, the tinel area got less sensitive). But after a bad movement with my arm (struggling putting on some shoes on from an high chair), I had serve pain, and after that (well I am not sure if it started immediately after or some hours later or even if it coincidence or related), I had a new symptom: dysesthesia, I have mild burning pain sensation on the skin along the nerve from the wrist up to the Tinel area, especially in the lower half of the forearm.

The symptoms of that also got better over the last month, but it is still there, the sensation is only a bit annoying, but beside that pretty normal. And the Tinel area is still there and static .(about the static, I think that I was able to trigger it a bit higher in the beginning but I am not sure about it, but the location is static for sure for the last month).
And the tinel area isn't a point, it is a segment that is 1/2 inch long. (with different sensitivity along it)

I had another EMG three weeks ago (because of the thumb, and the correct muscle is still not in the results, arggghh). sadly the neurologist didn't believe to my complaints of neuropathy symptoms. When I asked her to test that nerve she tested the median nerve (only later I found out by myself that the medial antebrachial cutaneous nerve fits to my description and location. a second neurologist didn't believe me too but two arm orthopedist agreed that it is a nerve issue, and the last one got to the same conclusion as mine from the symptoms [the first one blamed the ain nerve but it doesn't make sense because it is motor only nerve and it is very deep]).

It is annoying because that injured/sensitive nerve segment is irritated easily by the muscle near it and causes me to feel annoying sensation or mild pain above my wrist when I am using the muscles in my arm or stretching it.

Anyway, I hope that it will continue to get better, but I am trying to figure out what the hell happened to that nerve. I haven't got any answer. The only thing that happened in that area is the needle from the EMG test, but the closest insertion point was 2/3 inch from the nerve (to the direction of the nerve, but to the muscle below the muscle below it). I am 90% sure that the needle didn't get anywhere near that nerve. (I also got HPV vaccine on the same day that it started, but I doubt that it is related, maybe it was even a day after it started, don't remember exactly)

And what does the static tinel sign mean? As far as I understand, Tinel sign is usually happens in axonotmesis injuries, and it a sign for the regeneration of the axons (and it is static when it fails to regenerate), so if I have axon loss, why I had that sign pretty much from the beginning, before I had any sensation change? And why even now the sensation symptoms are so mild (and hopefully will continue to get better)? I understood that it can happens when the nerve is compressed too, but that nerve is just below the skin, so it can't be compressed, right?

Did anyone have any similar experience? Is it possible that the nerve got swollen or that it is some kind of inflammation of the nerve? would it explains my symptoms?

what do you recommend checking next? Should I test for something? (Right now I have an upcoming EMG in three weeks)

Thanks.
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