‘Saturday night palsy’ or ‘Sleep paralysis’ receives its name from episodes of unintentional prolonged radial nerve compression, because of sleeping after alcohol or drug intoxication.
Intoxicated individuals may not retain the reflexive ability to correct their position while asleep. Saturday night palsy classically involves an individual falling asleep with the arm hanging over a chair or other hard surface, leading to compression within the axilla.
The radial nerve is the commonly affected by compression injuries and most often results in the loss is loss of wrist, finger and thumb extension although triceps and forearm supination can also be affected depending on where the compression of the nerve has been.
The radial nerve is the largest nerve in the upper limb. It is a branch of the brachial plexus arising from the posterior cord with fibres originating from the C5, C6, C7, C8 and T1 roots. The radial nerve runs across the latissimus dorsi muscle, deep to the axillary artery.
Saturday night palsy is relatively common and has been reported to affect 2.97 per 100,000 men and 1.42 per 100,000 women.
Its clinical symptoms include motor weakness with sensory disturbances and are similar to stroke or a herniated cervical disk and other neuropathies, which makes it difficult to diagnose appropriately and, thus, sometimes leads to inappropriate evaluations.
Patients will often report symptom onset after consuming a large amount of alcohol and then sleeping in an unnatural position. Otherwise, patients may report some other mechanism by which compression would have been unnaturally placed on the upper medial arm or axilla.
Saturday night palsy
