Median nerve lesion – exam presentation

How to present a patient with a median nerve lesion for doctors, medical student exams, OSCES, PACES and USMLE

Example of how to present a case of an uncomplicated right median nerve palsy. To be read in conjunction with the neurological examination main page.

• I examined Mrs Clinton’s arms. There were no abnormal findings in the left arm
• On the right there was wasting of the thenar eminence (abductor policis brevis)
• There was general mild weakness of the power grip with specific weakness of abduction of the thumb
• There was sensory loss over the palmar surface of the thumb, index and middle fingers, as well as the medial half of the ring finger
• In summary, these findings are consistent with a median nerve lesion, the most common cause of which would be by compression of the median nerve in the carpal tunnel.

Click here for the neurological exam main page and here for questions on the neuro exam

Perfect revision for medical student finals, OSCES and PACES