Tinel sign

Tinel Sign is a medical sign used to detect irritated nerves. It is named after French neurologist Jules Tinel (1879–1952). The sign is positive when a tingling sensation, also known as paresthesia, is elicited by lightly tapping over the nerve.

History

The Tinel Sign was first described by Paul Hoffmann in 1915 and later by Jules Tinel in 1917. Both were studying patients with peripheral nerve injuries during World War I. Despite Hoffmann's earlier description, the sign is more commonly associated with Tinel due to his more detailed publications on the subject.

Technique

To perform the Tinel Sign test, the examiner lightly taps over the nerve to elicit a response. If the nerve is irritated, the patient will experience a tingling sensation or paresthesia. This sensation is often described as 'pins and needles' and may extend along the path of the nerve.

Clinical significance

The Tinel Sign is used to identify nerve irritation or damage. It is commonly used in the diagnosis of carpal tunnel syndrome, where the median nerve is compressed at the wrist. A positive Tinel Sign in carpal tunnel syndrome would result in tingling in the thumb, index finger, middle finger, and part of the ring finger.

The sign can also be used to monitor the recovery of injured nerves. As the nerve regenerates, the point at which the Tinel Sign is positive will move further along the nerve, indicating that recovery is taking place.

Limitations

While the Tinel Sign is a useful clinical tool, it is not without limitations. The sign is subjective and relies on the patient's report of symptoms. Additionally, the sign may be positive in individuals without nerve injury, particularly in those with heightened sensitivity to sensory stimuli.

See also

• Phalen's maneuver
• Carpal tunnel syndrome
• Peripheral neuropathy