PAIN SYNDROME AND FOCAL MYOKYMIA DUE TO ANTERIOR INTEROSSEOUS NEUROVASCULAR RELATIONSHIPS - REPORT OF A CASE AND NEUROPHYSIOLOGICAL CONSIDERATIONS

The anterior interosseous nerve can become entrapped within the antecu bital fossa at its origin from the median nerve, which results in the so-called Kiloh-Nevin syndrome. In this report, the authors describe a n atypical anterior interosseous nerve syndrome due to neurovascular r elationships with the anterior interosseous artery. The patient compla ined of unbearable analgesic-resistant pain within the forearm and foc al myokymia in muscles innervated by branches of the anterior inteross eous and distal median nerves. Pain and myokymia were alleviated by in flated blood pressure cuff compression in the bicipital region when th e arterial pulse was abolished distally. Microsurgical correction of t he pulsatile arterial compression resulted in relief from pain and myo kymia. Neurophysiological considerations of the mechanism underlying ' 'irritative'' neuropathy and myokymia are discussed.