Rehabilitation Management of a Patient with Median Nerve Entrapment from Venipuncture-associated Hematoma in Dengue Hemorrhagic Fever: A Case Report.

Autor:	Arboleda JS; Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila., Abiera JEH; Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila.; College of Medicine, University of the Philippines Manila., Anarna KS; Department of Rehabilitation Medicine, Philippine General Hospital, University of the Philippines Manila.
Jazyk:	angličtina
Zdroj:	Acta medica Philippina [Acta Med Philipp] 2024 Nov 15; Vol. 58 (20), pp. 121-126. Date of Electronic Publication: 2024 Nov 15 (Print Publication: 2024).
DOI:	10.47895/amp.v58i20.11014
Abstrakt:	Dengue hemorrhagic fever is a severe form of dengue presenting commonly with bleeding diathesis, but rarely with peripheral nervous system manifestations. Proximal median neuropathy comprises 1% of upper limb compression syndromes, and this case is the first to report injury to the proximal median nerve due to compression from hematoma formation. This case report presents the rehabilitation process of a 25-year-old Filipino female median nerve entrapment from venipuncture-associated hematoma presenting as burning sensation on the medial elbow, forearm and hand, weak flexion movement of her left thumb, index, and middle fingers. The patient was managed conservatively with pain medications, range of motion, gross and fine motor, and sensory re-education exercises. At 12 months, there was partial but functional recovery of median motor distribution and full recovery of median sensory distribution, as evidenced by improved sensory nerve action potential conduction velocity and amplitude, and compound motor action potential conduction velocity, with persistent decreased amplitude at 50%, and decrease in cross-sectional area of the left median nerve. This paper highlights the functional outcomes of a conservatively managed median nerve entrapment from venipuncture hematoma from dengue hemorrhagic fever. This case report also emphasizes that in the presence of severe bleeding risk of surgery in the background of severe thrombocytopenia, timely rehabilitation medicine referral with monitoring through clinical evaluation, musculoskeletal ultrasound, and electrodiagnostic study presents a viable alternative in the management of compression neuropathy. Competing Interests: All authors declared no conflicts of interest. (© 2024 Acta Medica Philippina.)
Databáze:	MEDLINE
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