The Clinical Problem Solvers Episode 410: Neurology VMR – right hand weakness for 3 months
Jul 31, 2025
Join neurologist Aaron Berkowitz and medical graduate Aye Chan Moe Thant as they delve into a fascinating case of a 19-year-old with persistent right-hand weakness. Aye shares her inspiring journey from Myanmar, advocating for health equity while analyzing neurological causes of the patient's symptoms. They explore critical topics like brachial plexus functions, diagnostic techniques, and the intrigued implications of rare conditions like Hirayama disease. Tune in for a captivating discussion that demystifies neurology and promotes understanding!
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Localizing Isolated Hand Weakness
- Isolated right hand weakness likely localizes to peripheral nerves or a small central lesion in the hand area of motor cortex.
- Central lesions causing isolated hand weakness are rare but possible, such as a stroke in the 'hand knob' area of the motor cortex.
Master Key Arm Nerves
- Learn the five main nerves of the arm: musculocutaneous, axillary, radial, median, and ulnar to simplify peripheral nerve localization.
- Use these nerves' muscle and sensory territories to differentiate nerve, root, or plexus lesions clinically.
Ulnar Nerve Dominates Hand Intrinsics
- Most intrinsic hand muscles are innervated by the ulnar nerve, including interossei which control finger abduction and adduction.
- Sensory territories help distinguish median, ulnar, and radial nerve involvement, aiding diagnosis of focal neuropathies.
