The patient reported that he had been carrying out normal activities the previous day without any injury or overexertion of his arm. He habitually sleeps with his arm under his head as a pillow. The night before admission, he consumed alcohol and went to bed at 9 p.m., maintaining his habit of sleeping with his arm under his head.

At 2 a.m., he woke up with numbness in his entire right hand and forearm. His wrist was drooping and he couldn't straighten it, even after massaging the area. He was subsequently transferred to the Stroke Center at Phu Tho Provincial General Hospital.

An MRI scan of his brain showed no damage to the brain tissue. Nerve conduction studies of his upper limbs revealed reduced motor amplitude in the right radial nerve in the forearm segment. The possibility of a stroke was ruled out. He was diagnosed with radial nerve palsy due to compression, a classic condition known in medical literature as "saturday night palsy". The mechanism involves compression of the radial nerve in the arm or forearm.

The patient received medical treatment (medication) combined with physiotherapy and rehabilitation. After 14 days, his hand almost fully recovered, and he was able to write legibly.

Doctor Ta Van Hai, deputy head of the Subacute Stroke – Neurological Treatment Department at the Stroke Center, explained that saturday night palsy is paralysis of the deep branch of the radial nerve. It often occurs when someone consumes alcohol before sleeping, leading to deep sleep and loss of control over sleeping posture. Examples include draping an arm over a chair, sleeping with an arm under the head all night, or allowing someone else to rest their head on one's arm for an extended period without changing positions.

"This compresses and stretches the radial nerve for an extended period, resulting in nerve damage and the characteristic 'wrist drop' seen in this patient," Dr. Hai said.

In mild cases of saturday night palsy, patients experience slight weakness and numbness. With prompt and appropriate treatment, recovery typically occurs within 2-4 weeks. More severe cases can cause muscle atrophy, joint stiffness, and paralysis, making treatment more challenging and prolonged.

Image of the patient's hand with radial nerve palsy, showing the characteristic "wrist drop". Photo: Hospital provided

Image of the patient's hand with radial nerve palsy, showing the characteristic "wrist drop". Photo: Hospital provided

Doctors advise against using one's arm as a pillow or lying on one's side, compressing the arm. Limiting alcohol consumption before sleep is also recommended, as it can lead to deep sleep and nerve compression. Young people should also avoid letting others use their arm as a pillow for extended periods, as radial nerve compression can cause temporary paralysis.

Anyone experiencing numbness and weakness in the arm or forearm muscles should seek immediate medical attention from a specialist for prompt diagnosis and treatment to prevent lasting complications.

Le Nga