Paralysis of the Median Nerve

Mild incomplete paralysis. Mild neuralgia or paresthesias in the distribution of the median nerve (thumb, index, middle finger, and radial half of ring finger), with minor sensory deficits and minimal functional impairment.

Moderate; 30

Moderate incomplete paralysis. Weakness of grip and pinch strength, loss of opposition of the thumb ("ape hand" deformity), significant sensory deficits affecting grip and fine motor tasks, with moderate functional limitation of the hand.

Severe; 50

Moderately severe incomplete paralysis. Pronounced grip weakness, inability to oppose the thumb effectively, thenar muscle atrophy, significant sensory loss in the affected fingers, and marked functional limitation of the hand affecting activities of daily living.

Complete; the hand inclined to the ulnar side, the index and middle fingers more extended than normally, considerable atrophy of the muscles of the thenar eminence, the thumb in the plane of the hand (ape hand); pronation incomplete and defective, absence of flexion of index finger and feeble flexion of middle finger, cannot make a fist, index and middle fingers remain extended; cannot flex distal phalanx of thumb, defective opposition and abduction of the thumb, at right angles to palm; flexion of wrist weakened; pain with trophic disturbances; 70

Complete paralysis. Loss of all median nerve motor function: inability to flex the index and middle fingers, total loss of thumb opposition, inability to pronate the forearm fully, complete thenar atrophy, and total sensory loss in the median nerve distribution, rendering the hand largely non-functional.