Tinel's sign explained

Field:	Neurology, Plastic surgery
Differential:	Peripheral neuropathy, Radiculopathy, Plexopathy

Tinel's sign (also Hoffmann-Tinel sign) is a way to detect irritated nerves. It is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or "pins and needles" in the distribution of the nerve. Percussion is usually performed moving distal to proximal. It is named after Jules Tinel.^{[1] [2] [3]}

It is a potential sign of carpal tunnel syndrome, cubital tunnel syndrome, anterior tarsal tunnel syndrome and symptomatic neuroma.^[4]

History

Tinel's sign takes its name from French neurologist Jules Tinel (1879–1952), who wrote about it in a journal article published in October 1915. German neurologist Paul Hoffmann independently also published an article on tinel sign six months earlier, in March 1915.^{[5] [6]} Previously, in 1909, Trotter and Davies published their findings that sensations elicited distal to the point of nerve resection are referred to the area or point of nerve resection; however they "failed to comment on the clinical relevance of their observation."^[6]

See also

• Hoffmann's sign
• Phalen maneuver

Notes and References

1. Tinel, J. (1978) The "tingling sign" in peripheral nerve lesions (Translated by EB Kaplan). In: M. Spinner M (Ed.), Injuries to the Ma jor Branches of Peripheral Nerves of the Forearm. (2nd ed.) (pp 8–13). Philadelphia: WD Saunders Co
2. Tinel, J. (1915) Le signe du fourmillement dans les lésions des nerfs périphériques. Presse médicale, 47, 388–389
3. Tinel, J., Nerve wounds. London: Baillère, Tindall and Cox, 1917
4. Wolvetang. Nicolaas H. A.. Lans. Jonathan. Verhiel. Svenna H. W. L.. Notermans. Bo J. W.. Chen. Neal C.. Eberlin. Kyle R.. June 2019. Surgery for Symptomatic Neuroma: Anatomic Distribution and Predictors of Secondary Surgery. Plastic and Reconstructive Surgery. en. 143. 6. 1762–1771. 10.1097/PRS.0000000000005664. 30907815. 0032-1052. free.
5. Wartenberg . Robert . Robert Wartenberg . Babinski Reflex and Marie-foix Flexor Withdrawal Reflex: Historical Notes . June 1951 . AMA Archives of Neurology & Psychiatry . 55 . 6 . 713–716 . 10.1001/archneurpsyc.1951.02320060056006 . 14829100 . January 24, 2021 . The very same phenomenon, however, had been described by Paul Hoffmann in a German medical periodical in the issue of March 28 of the same year. The Germans, therefore, speak of the Hoffmann-Tinel sign..
6. Sansone . Jason M. . Gatzke . Angela M. . Aslinia . Florence . Rolak . Loren A. . Yale . Steven H. . Jules Tinel (1879-1952) and Paul Hoffmann (1884-1962) . March 2006 . Clinical Medicine & Research . 4 . 1 . 85–89 . 10.3121/cmr.4.1.85 . 16718952 . 1435662 . Dr. Paul Hoffmann described the sign in March of 1915 in On a Method of Evaluating the Success of a Nerve Suture. Several months later in October 1915, Dr. Jules Tinel published his work on the sign in The Sign of Tingling in Lesions of Peripheral Nerves..