Entrapment neuropathy of the lateral antebrachial cutaneous nerve is relatively uncommon. It should be considered in the differential diagnosis of pain at the elbow and paresthesia of the distal forearm. The lateral antebrachial cutaneous nerve is the sensory terminal branch of the musculocutaneous nerve. It emerges from beneath the lateral margin of the biceps about 2-5 cm proximal to the elbow flexion crease. Entrapment of the lateral antebrachial cutaneous nerve can occur at that point .

Materials and Methods: Between 1984 and 2000, 23 patients were diagnosed with entrapment of the lateral antebrachial cutaneous nerve (LABC). There were 15 men and eight women, ranging in age between 19 to 64, with an average of 38 years. There was a history of trauma to the elbow region in eight patients. Seventeen patients were workers’ compensation cases. All patients complained of pain in the anterolateral aspect of the elbow. Eleven patients had numbness and paresthesia along the radial aspect of the distal forearm. Clinical examination revealed localized tenderness over the anterolateral aspect of the elbow approximately 5 cm proximal to the elbow flexion crease in all patients. Six patients had decreased sensibility along the radial aspect of the distal forearm. Tinel’s sign was positive over the LABC at the elbow level in six patients. Electrodiagnostic studies using Spindler and Felsenthal’s technique were positive in all patients. All patients were treated conservatively. Seven patients improved with the conservative treatment, and 16 patients underwent surgical exploration of the LABC nerve under regional anesthesia. One patient had bilateral involvement and he underwent bilateral exploration of the nerves. The time between onset of symptoms and surgery averaged 14 weeks, ranging from 6-54 weeks. The postoperative follow-up ranged from 2-16 years, with an average of 68 months.

Results: Fourteen patients had complete relief of pain following surgical release. Two patients had minimal tenderness. The paresthesia completely improved in 15 patients. Only one patient had persistent dysesthesias along the radial side of the distal forearm. All workers’ compensation patients went back to their original work activities. At the time of the last follow-up, the patients’ grip strength returned to normal values.

Conclusion: Entrapment neuropathy of the lateral antebrachial cutaneous nerve should be considered in the differential diagnosis of pain at the elbow and paresthesias of the distal forearm. If conservative treatment is not effective in improving the patient’s symptoms, then surgical decompression is associated with excellent results.