# Subacute High-Grade Ulnar Neuropathy Without Trauma: A Case of Cubital Tunnel Syndrome

## TL;DR

A woman experienced sudden severe ulnar nerve issues without trauma, leading to a rare case of cubital tunnel syndrome requiring quick treatment.

## Contribution

This case report highlights an unusual acute presentation of cubital tunnel syndrome without prior trauma.

## Key findings

- A 46-year-old woman awoke with claw deformity and sensory loss consistent with moderate CuTS.
- Electrodiagnostic studies showed subacute and chronic nerve changes at the elbow.
- Surgical release led to rapid sensory improvement but delayed motor recovery.

## Abstract

Cubital tunnel syndrome (CuTS) typically presents gradually, and an acute overnight onset of severe ulnar neuropathy is rare. A 46-year-old female recreational pickleball player awoke with a right-hand claw deformity and sensory loss without preceding symptoms or trauma. Examination showed intrinsic weakness and decreased ulnar sensation; electrodiagnostic studies revealed subacute on chronic axonal and demyelinating changes at the elbow consistent with moderate CuTS. She underwent cubital tunnel release one week after onset, with rapid sensory improvement but delayed motor recovery. This case highlights an atypical acute presentation of CuTS and underscores the importance of prompt evaluation and timely intervention to mitigate persistent deficits.