REVIEW

Kiloh-Nevin Syndrome: a literature review

Síndrome de Kiloh-Nevin: uma revisão de literatura

  • Maria Clara Cardoso Seba1    Maria Clara Cardoso Seba1
  • Henrique Nicola Santo Antonio Bernardo1    Henrique Nicola Santo Antonio Bernardo1
  • Manuela Guedes Pereira2    Manuela Guedes Pereira2
  • David Furtado Cavalcante Vecina3    David Furtado Cavalcante Vecina3
  • Amanda Correa Andari3
  • Eduardo Tadeu Santana4
  • Paulo Henrique Pires de Aguiar5,6,7    Paulo Henrique Pires de Aguiar5,6,7
  Views: 979
  Downloads: 53

Resumo

A síndrome de Kiloh-Nevin ou síndrome do nervo interósseo anterior é uma doença rara caracterizada por fraqueza de flexão da articulação interfalangiana do polegar e das articulações interfalangianas terminais do dedo indicador, acompanhada de fraqueza de pronação do antebraço quando o cotovelo está fletido. Sua fisiopatologia ainda não está totalmente esclarecida: alguns autores sugerem uma neuropatia compressiva, mas novas evidências apoiam a teoria de uma neurite idiopática ou mesmo imunomediada. O diagnóstico de AINS consiste na história clínica, exame físico com sinal de Kiloh-Nevin positivo e pode incluir eletromiografia e ressonância magnética. A literatura mostra que os pacientes com este quadro clínico são frequentemente tratados de forma conservadora nos primeiros meses, com analgésicos, anti-inflamatórios não esteroidais e fisioterapia. Alguns artigos sugerem uma abordagem cirúrgica com descompressão do nervo medial. O objetivo deste artigo é fazer uma revisão das principais referências disponíveis sobre a síndrome.

Palavras-chave

Síndrome do nervo interósseo anterior; Síndrome de Kiloh-Nevin; Neurocirurgia

Abstract

Kiloh-Nevin syndrome or anterior interosseous nerve syndrome (AINS) is a rare condition characterized by weakness of flexion of the interphalangeal joint of the thumb and terminal interphalangeal joints of the index finger accompanied by weakness of pronation of the forearm when the elbow is flexed. The pathophysiology is not yet fully understood: some authors suggest a compressive neuropathy, however new evidence supports the theory of an idiopathic or even immune-mediated neuritis. The diagnosis of AINS consists of clinical history, physical examination with a positive Kiloh-Nevin sign and may include electromyography (EMG) and magnetic resonance imaging (MRI). The literature shows that patients with this clinical condition are often treated conservatively in the first few months, with analgesics, non-steroidal anti-inflammatory drugs and physiotherapy. Some articles suggest a surgical approach with decompression of the medial nerve. The objective of this article is to review the main references available on AINS.

Keywords

Anterior interosseous nerve syndrome; Kiloh-Nevin syndrome; Neurosurgery

References

1. Li N, Russo K, Rando L, Gulotta-Parrish L, Sherman W, Kaye AD. Anterior interosseous nerve syndrome. Orthop Rev. 2022;14(4):38678. http://doi.org/10.52965/001c.38678. PMid:36225171.
2. Rabaut V, VandeVyver V, Verstraete K. Kiloh-Nevin syndrome. J Belg Soc Radiol. 2020;104(1):49. http://doi.org/10.5334/jbsr.2183. PMid:32964190.
3. Krishnan KR, Sneag DB, Feinberg JH, Wolfe SW. Anterior interosseous nerve syndrome reconsidered: a critical analysis review. JBJS Rev. 2020;8(9):e2000011. http://doi.org/10.2106/JBJS.RVW.20.00011. PMid:32890049.
4. Komaru Y, Inokuchi R. Anterior interosseous nerve syndrome. QJM. 2017;110(4):243. http://doi.org/10.1093/qjmed/hcw227. PMid:28073933.
5. Na KT, Jang DH, Lee YM, Park IJ, Lee HW, Lee SU. Anterior interosseous nerve syndrome: is it a compressive neuropathy? Indian
J Orthop. 2020;54(Suppl 1):193-8. http://doi.org/10.1007/s43465-020- 00099-2. PMid:32952930.
6. Sneag DB, Arányi Z, Zusstone EM, et al. Fascicular constrictions above elbow typify anterior interosseous nerve syndrome. Muscle Nerve. 2020;61(3):301-10. http://doi.org/10.1002/mus.26768. PMid:31773766.
7. Aljawder A, Faqi MK, Mohamed A, Alkhalifa F. Anterior interosseous nerve syndrome diagnosis and intraoperative findings: a case report. Int J Surg Case Rep. 2016;21:44-7. http://doi.org/10.1016/j.ijscr.2016.02.021. PMid:26921536.
8. Nzeako OJ, Tahmassebi R. Idiopathic anterior interosseous nerve dysfunction. J Hand Surg Am. 2015;40(11):2277-8. http://doi. org/10.1016/j.jhsa.2015.07.021. PMid:26328903.
9. Pham M, Bäumer P, Meinck HM, et al. Anterior interosseous nerve syndrome: fascicular motor lesions of median nerve trunk. Neurology. 2014;82(7):598-606. http://doi.org/10.1212/WNL.0000000000000128. PMid:24415574.
10. Strohl AB, Zelouf DS. Ulnar tunnel syndrome, radial tunnel syndrome, anterior interosseous nerve syndrome, and pronator syndrome. J Am Acad Orthop Surg. 2017;25(1):e1-10. http://doi. org/10.5435/JAAOS-D-16-00010. PMid:27902538.
11. Tyszkiewicz T, Atroshi I. Bilateral anterior interosseous nerve syndrome with 6-year interval. SAGE Open Med Case Rep. 2018;6:2050313X1877741. http://doi.org/10.1177/2050313X18777416. PMid:29796273.
12. Caetano EB, Vieira LA, Sabongi JJ No, Caetano MBF, Sabongi RG. Anterior interosseous nerve: anatomical study and clinical implications. Rev Bras Ortop. 2018;53(5):575-81. http://doi.org/10.1016/j. rboe.2018.07.010. PMid:30245997.
13. Rao YL, Pai MM, Krishnaprasad PR, Murlimanju BV, Mamatha T, Prabhu LV. Exploring the morphology of anterior interosseous nerve and relating it to its clinical conditions. Turk Neurosurg. 2020;31(1):107-11.


1MS, Medical student, Faculdade de Medicina ABC – FMABC, Santo André, SP, Brasil.

2MS, Medical student, Faculdade de Medicina de Catanduva – FAMECA, Catanduva, SP, Brasil.

3Medical student, Faculdade de Medicina, Pontifícia Universidade Católica de São Paulo – PUC-SP, Sorocaba, SP, Brasil.

4Phys ed, PhD in Reahabilitation Sciences, Assistant professor of Anatomy, ABC Medical School – FMABC, Santo André, SP, Brasil.

5MD, PhD, Neurosurgeon, Professor, Faculdade de Medicina ABC – FMABC, Santo André, SP, Brasil.

6MD, PhD, Neurosurgeon, Professor, Department of Neurology, Pontifícia Universidade Católica de São Paulo – PUC-SP, Sorocaba, SP, Brasil.

7MD, PhD, Neurosurgeon, Professor, Department of Neurosurgery, Hospital Santa Paula, São Paulo, SP, Brasil.

 

Received Mar 11, 2024

Accepted Apr 2, 2024

JBNC  Brazilian Journal of Neurosurgery

JBNC
  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786
iThenticate
Open Access

Contact

Social Media

   

ABNc  Academia Brasileira de Neurocirurgia

  •   Rua da Quitanda 159 – 10º andar - Centro - CEP 20091-005 - Rio de Janeiro - RJ
  •   +55 21 2233.0323
  •    abnc@abnc.org.br

Sponsor

  • Brain4Care
  • Hospital INC
  • Strattner
  • Zeiss