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January 28, 1974

Minimal Pressure Neuropathy

JAMA. 1974;227(4):439. doi:10.1001/jama.1974.03230170055021

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To the Editor.—  This communication is offered in the hope that your readers may be able to confirm my observation on two forms of what might be characterized as "minimal pressure neuropathy."A specific rhythmic twitching of the first dorsal interosseus muscle results in small regular abduction motions of the index finger. This is at times accompanied by matching adduction motions of the thumb in the same rhythm. These persons have subjected the arm or wrist to a mild pressure over the ulnar nerve, most often by a watchband. Improvement or disappearance of the symptoms follows removal of the source of the pressure.Fasciculatory twitching of the small muscles of the lower eyelid, just under the eye, usually one-sided, less often bilaterally with one side worse, appears in an irregular, recurrent, or remittent course.Our usual diagnostic categories identify several patterns of facial movement disorder, none of which apply satisfactorily