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Spinal cord lesions at T1 level:

  • syringomyelia
  • compression of T1 segment due to cervical spondylosis, neurofibroma
  • tumour
  • motor neurone disease

Root lesions eg T1 compression by a disc lesion

Brachial plexus lesions:

  • trauma, irradiation, infiltration
  • thoracic outlet obstruction
  • Klumpke's paralysis

Peripheral nerve lesions:

  • median lesions, ulnar nerve lesions
  • peripheral motor neuropathy


  • distal myopathy
  • myotonic dystrophy (forearms are more often affected than the hands)

Trophic disorders:

  • disuse eg arthritis
  • ischaemia eg vasculitis
  • shoulder-hand syndrome

Note that in discriminating an ulnar nerve lesion from a T1 root lesion remember that in a T1 root lesion there is no sensory loss that affects the hand.

Last reviewed 01/2018