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Enlarged Peripheral Nerves
  1. Michael Donaghy
  1. Department of Clinical Neurology, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE, UK

    Abstract

    Enlargement of peripheral nerve is a physical sign that all neurologists know about, but which, like pes cavus, is extremely difficult to recognize in its milder forms. It is associated principally with two conditions – leprosy and hereditary motor and sensory neuropathy. It has also been noted in a number of others (Table 1).

    DETECTING ENLARGED PERIPHERAL NERVES BY PALPATION

    Potential sites for palpating nerves are shown in Fig. 1, based on experience in leprosy. Attempts to palpate such nerves are best made using the tips of the index, middle and ring fingers rolled backwards and forwards across the long axis of the nerve. Sometimes you can try to pick up the nerve between the thumb and middle finger as in the case of the ulnar nerve in the upper arm.

    Only the most astute physician will be able to use his thumb to detect an enlarged superficial radial nerve in

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