The Double Crush Syndrome (DCS) refers to the occurrence of two points of nerve entrapment and/or compression in the same neurologic distribution.
Essential features:
(1) radiculopathy
(2) peripheral entrapment neuropathy
The most common pairing is that of cervical radiculopathy and ulnar or median nerve entrapment. It can also involve a lumbosacral radiculopathy and peripheral entrapment in the lower extremity. Rarely it may involve nerves of the head and neck.
Some cases may be related to traumatic injury.
Some cases may be related to tumor growth.
Some cases are iatrogenic.
Significance:
(1) Symptoms of one entrapment may mask features of the other.
(2) Disability may greater than that seen at one site. Signs and symptoms may be atypical.
(3) Correction of one entrapment alone will result in resolution of neurological findings.
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