BILATERAL MEDIAN AND ULNAR NEUROPATHY AT THE WRIST IN A PARQUET FLOORER

Many cases of work related compression neuropathy of the ulnar and med ian nerves at the wrist have been described. This report presents a ca se of bilateral distal neuropathy of the median and ulnar nerves in a parquet floorer, who laid wooden block flooring by hand and used the p alms and volar surface of both hands to hit the blocks into place. He also used an electric sander and polisher. Bilateral numbness and para esthesias in all fingers had been present for about one year. Clinical examination was normal; the neurological assessment indicated slight impairment in response to tactile, heat, and pain stimuli in all 10 fi ngers. Electroneurography showed increased distal motor latencies of m edian and ulnar nerves at both wrists, although the lower limbs were n ormal. The results of blood, urine, and instrumental tests excluded sy stemic disease or local factors that could cause compression neuropath y. After stopping work for three months, the clinical picture and elec troneurographic results improved. These data support the hypothesis th at the damage to the median and ulnar nerves had been caused by the pa tient's way of working, which provoked repeated bilateral microtrauma to his wrists. To diagnose work related multiple neuropathy can be dif ficult and an accurate work history is necessary. Preventive measures and diligent health care are required for this category of worker.