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LETTER TO EDITOR
Year : 2021  |  Volume : 69  |  Issue : 6  |  Page : 1895

Kayaking Palsy


Department of Angioneurology, Research Center of Neurology 125367, Volokolamskoe Shosse, 80, Moscow, Russia

Date of Submission21-Jan-2021
Date of Decision21-Jan-2021
Date of Acceptance29-Mar-2021
Date of Web Publication23-Dec-2021

Correspondence Address:
Dr. Polina I Kuznetsova
115580, Shipilovskaya Street, 60/1, 514, Moscow
Russia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.333512

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How to cite this article:
Raskurazhev AA, Kuznetsova PI, Tanashyan MM. Kayaking Palsy. Neurol India 2021;69:1895

How to cite this URL:
Raskurazhev AA, Kuznetsova PI, Tanashyan MM. Kayaking Palsy. Neurol India [serial online] 2021 [cited 2022 Jan 26];69:1895. Available from: https://www.neurologyindia.com/text.asp?2021/69/6/1895/333512




Dear Sir,

A certified neurologist (AR), 32 years, decided to try kayaking while on vacation, with no prior experience. After a tour of five hours, he noticed weakness in the right hand (could not open a bottle of water) without any sensory symptoms. He was examined by his wife, also a certified neurologist (PK), which revealed (a) loss of little finger adduction, (b) moderate weakness of the interosseous muscles with loss of second finger abduction, (c) positive Froment's sign in the right hand, (d) fasciculations in the first interosseous muscle, and (e) no sensory deficit. He could not turn keys in keyholes, had difficulties using a spoon, and could not hold the phone between the first and index fingers.

A diagnosis of ulnar neuropathy in the Guyon's canal was suspected – the so-called “cyclist's palsy” or “handlebar palsy,” a condition associated with trauma and/or repetitive stress during long-distance biking. It usually involves branches of the ulnar nerve passing through or immediately after the ulnar tunnel. In our case, the most probable pathology was an injury to the deep motor branches of the ulnar nerve, sparing the sensory portion [Figure 1].
Figure 1: Ulnar nerve anatomy at the Guyon's canal

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The symptoms progressively improved in the course of two weeks, with nonsteroid anti-inflammation drugs used for the first 2 or 3 days, followed by ipidacrine, vitamins B1 and B6, and pentoxifylline per os (a purely empirical therapeutic regimen). This condition is usually self-limiting, does not require medication (with one major exception – plenty of rest), and goes away on its own, yet the nature of symptoms may feel worrisome and even menacing, especially to one of a medical profession.

A somewhat similar case was described in the New England Journal of Medicine, which was called “paddler's palsy,”[1] but the distribution of symptoms was linked to traction injury of the brachial plexus. Although benign, the absence of sensory symptoms in a pure motor deficit in a case of “kayaking palsy” may go unnoticed for long periods of time, leading to more nerve damage and delayed recovery.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Rhodes CH, Thadani VM. Paddler's palsy. N Engl J Med 1996;334:125-6.  Back to cited text no. 1
    


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