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We present a case of a man with unilateral adductor pollicis (AdP) and first dorsal interosseous (FDIO) muscle weakness with sparing of the hypothenar muscle group. Case report: A 57-year-old man developed progressive weakness over 3 months in his right hand without sensory abnormalities. Clinical and electrodiagnostic examination revealed abnormalities in the FDIO. Clinical examination supported an abnormal AdP. Hypothenar muscle groups were intact, suggestive of an ulnar nerve lesion in the palm, an uncommon area of entrapment. MRI confirmed a ganglion cyst between the third and fourth metacarpal bases, compressing the deep palmar branch of the ulnar nerve. After removal of the cyst and neurolysis of the ulnar motor branch, AdP and FDIO strength improved five months postoperatively. Conclusion: This deficit was caused by compression of the deep palmar branch of the ulnar nerve by a ganglion cyst in the mid palm, an uncommon area. Suspected ulnar neuropathies caused by etiologies at the wrist or palm, a combination of clinical evaluation, nerve conduction studies, and anatomic studies may reveal uncommon sites of compression.

international journal of physiatry

Isolated Neuropathy of the Motor Branch of the Ulnar Nerve Sparing the Hypothenar Muscle and Ulnar Intrinsic Groups due to Compressive Lesion: A Case Report