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April 6, 1984

Unusual Mechanism of `Gold Neuropathy'

Author Affiliations

Stanford University Medical Center Stanford, Calif

JAMA. 1984;251(13):1682. doi:10.1001/jama.1984.03340370022015

To the Editor.—  I wish to report an unusual case of "gold neuropathy."

Report of a Case.—  A healthy man received as a present a solid 18-karat gold watch and bracelet. After 3 1/2 weeks of continuous wear, he experienced paresthesia in the medial and dorsal aspect of his left thumb. On examination, a small area of hypesthesia was found and a positive Tinel sign was elicited by tapping over the dorsal and lateral distal end of the radius. Two weeks after he stopped wearing the watch, the symptoms disappeared.

Comment.—  Superficial radial neurapraxia has been previously described,1 caused by an extremely tight watchband. In the present case, the bracelet was not tight, and the likely explanation for the compression neuropathy relates to the weight of the gold watch and bracelet. Given that the specific gravity of gold (19.1) is much higher than that of steel or even lead,