Distal, "Tinel-like" percussion paresthesiae, with proximal nerve lesions.

Can proximal nerve lesions cause a distal "Tinel-like" sign? We present the case studies of two patients with documented cervical root lesions who exhibited percussion paresthesiae distally in the absence of any clinical or nerve conduction evidence of distal pathology. The possible mechanisms underlying such manifestation, which has been previously reported in the literature, are explored, and a case is made for the phenomenon being related to the "distortion" of a normal sensory signal when it encounters an area of spatial inhomogeneity proximally along the nerve.