Hoffmann-Tinel sign

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The Hoffmann-Tinel sign is a clinical sign that is examined in the neurological examination under certain questions. It refers to the demyelinating and remyelinating processes of peripheral nerves . It is named after Paul Hoffmann (1884–1962, physiologist in Freiburg) and Jules Tinel (1879–1952, neurologist in Paris).

It plays a special role in the diagnosis of carpal tunnel syndrome : it is examined there by tapping the volar (inner) side of the wrist. If there is pressure damage to the median nerve in the carpal tunnel , it becomes positive: The person examined feels an unpleasant, electrifying feeling in the distal, sensitive supply area of ​​the medianus, i.e. in the thumb, index and middle finger. It can also be triggered in the event of damage to other, superficial nerves, by tapping the course of the nerve or the suspected lesion site. The abnormal sensations occur because the newly sprouting nerve fibers are only thinly myelinated and are directly irritated by mechanical stress on the nerve.

In Hoffmann's publication, it is used to assess the success of surgical nerve sutures: With uncomplicated reinnervation, one would expect the axon to grow by around 1–5 mm per day. The point in the course of the nerve where the sign becomes positive shows its current position. Ideally, it should move gradually along the nerve road towards the organ of success.

Similar research

literature

Original work

  • Paul Hoffmann: About a method for assessing the success of a nerve suture. In: Medical Clinic. 1915a, 13, pp. 359-360.
  • Paul Hoffmann: More about the behavior of freshly regenerated nerves and a method for assessing the success of a nerve suture at an early stage. In: Medical Clinic. 1915b, 31, pp. 856-858.
  • Jules Tinel: Le signe du fourmillement dans les lésions des nerfs périphériques. In: La Presse Médicale. Paris 1915, 23, pp. 388-389.