45-year-old female presented with a 2-month history of numbness and
tingling in her right hand. The symptoms, which were localized to the fingers,
occurred throughout the day and wakened the patient at night. She reported that
the symptoms were partially relieved by “shaking” her hand. The patient also
reported weakness in her right hand, causing her difficulty in carrying her
briefcase. Physical examination revealed asymmetric weakness on thumb
adduction with evidence of thenar atrophy. Sensation to two-point discrimination
testing was impaired in the first and second fingers of the patient’s right hand.
She had a negative Phalen sign but a positive Hoffmann-Tinel sign.