Which condition presents with numbness or paresthesias in the little finger and hypothenar region, particularly at night?

Which condition presents with numbness or paresthesias in the little finger and hypothenar region, particularly at night?

• A. Cubital tunnel syndrome
• B. Pronator syndrome
• C. Cheiralgia paresthetica
• D. Anterior interosseous syndrome

Answer: (A)

Compression of the ulnar nerve as it passes behind the elbow (cubital tunnel) produces numbness or paresthesias in the little finger and the ulnar side of the hand, often worse at night when the elbow is flexed and the tunnel is compressed. The sensory area affected matches the ulnar distribution, including the little finger and hypothenar region, and there can be involvement of intrinsic hand muscles with prolonged compression. This pattern helps distinguish it from other conditions: pronator syndrome (median nerve at the elbow) typically affects the thumb, index, middle, and the radial half of the ring finger; cheiralgia paresthetica involves the radial nerve at the wrist with dorsal hand symptoms; anterior interosseous syndrome is a motor problem in the forearm without hand numbness. So the described nocturnal numbness in the little finger and hypothenar region fits cubital tunnel syndrome.

Compression of the ulnar nerve as it passes behind the elbow (cubital tunnel) produces numbness or paresthesias in the little finger and the ulnar side of the hand, often worse at night when the elbow is flexed and the tunnel is compressed. The sensory area affected matches the ulnar distribution, including the little finger and hypothenar region, and there can be involvement of intrinsic hand muscles with prolonged compression. This pattern helps distinguish it from other conditions: pronator syndrome (median nerve at the elbow) typically affects the thumb, index, middle, and the radial half of the ring finger; cheiralgia paresthetica involves the radial nerve at the wrist with dorsal hand symptoms; anterior interosseous syndrome is a motor problem in the forearm without hand numbness. So the described nocturnal numbness in the little finger and hypothenar region fits cubital tunnel syndrome.