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Peripheral nerve entrapment

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https://www.readbyqxmd.com/read/28522988/multiple-sites-ultrasonography-of-peripheral-nerves-in-differentiating-charcot-marie-tooth-type-1a-from-chronic-inflammatory-demyelinating-polyradiculoneuropathy
#1
Jingwen Niu, Liying Cui, Mingsheng Liu
INTRODUCTION: Multiple sites measurement of cross-sectional areas (CSA) by ultrasound was performed to differentiate Charcot-Marie-Tooth type 1A (CMT1A) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). METHODS: Nine patients with CMT1A, 28 patients with CIDP, and 14 healthy controls (HC) were recruited prospectively. Consecutive ultrasonography scanning was performed from wrist to axilla on median and ulnar nerves. CSAs were measured at 10 predetermined sites of each nerve...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28502561/acute-hydrocephalus-due-to-a-primary-malignant-peripheral-nerve-sheath-tumor-of-the-cervicothoracic-junction-a-case-report-and-review-of-the-literature
#2
Y Samanci, H S Togay, R Yakar, F Kabukcuoglu, S E Celik
BACKGROUND: The estimated incidence of malignant nerve sheath tumors is 0.001% per year, and only 2-3% of those tumors involve the spinal nerves. We present a rare case of acute hydrocephalus caused by primary malignant peripheral nerve sheath tumor of the cervicothoracic junction. CASE DESCRIPTION: A 29-year-old previously healthy male patient, except for a history of two previous surgeries for ulnar nerve entrapment and progressive left upper extremity weakness, presented with acute onset somnolence...
May 11, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28500566/an-update-on-addressing-important-peripheral-nerve-problems-challenges-and-potential-solutions
#3
Wilson Z Ray, Mark A Mahan, Danzhu Guo, Danqing Guo, Michel Kliot
From time to time it is thoughtful and productive to review a medical field and reflect upon what are the major issues that need to be addressed and what is being done to do so. This review article is not meant to be all-inclusive but rather focuses on four evolving areas in the field of peripheral nerve disorders and treatments: (1) nerve surgery under ultrasound guidance using a new ultra-minimally invasive thread technique; (2) evolving magnetic resonance imaging (MRI) and ultrasound imaging techniques that are helping to both diagnose and treat a variety of peripheral nerve problems including entrapment neuropathies, traumatic nerve injuries, and masses arising from nerves; (3) promoting recovery after nerve injury using electrical stimulation; and (4) developing animal models to reproduce a severe nerve injury (neurotmetic grade in continuity) that requires a surgical intervention and repair...
May 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28400666/limited-incision-carpal-tunnel-release
#4
Sunil Gaba, Sandeep Bhogesha, Onkar Singh
BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Limited incision techniques for carpal tunnel release are gaining popularity. The main advantages of these techniques are less scar load, less pillar pain, shorter recovery, and return-to-work time. However, the completeness of release, and risk of neurovascular injury are always a concern. We devised a method of limited incision release with two mini-incisions and use of nasal speculum and a probe...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28375915/common-entrapment-neuropathies
#5
Lisa D Hobson-Webb, Vern C Juel
PURPOSE OF REVIEW: This article addresses relevant peripheral neuroanatomy, clinical presentations, and diagnostic findings in common entrapment neuropathies involving the median, ulnar, radial, and fibular (peroneal) nerves. RECENT FINDINGS: Entrapment neuropathies are a common issue in general neurology practice. Early diagnosis and effective management of entrapment mononeuropathies are essential in preserving limb function and maintaining patient quality of life...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28355676/imaging-nerve-pathology-of-the-knee-magnetic-resonance-imaging-and-ultrasound
#6
Yoav Morag, Lynda J S Yang
Peripheral neuropathies are not uncommon, and the diagnostic evaluation includes a clinical assessment and electrophysiologic studies as well as diagnostic imaging. Magnetic resonance imaging (MRI) and high-resolution ultrasound (HRUS) are of special importance in providing the surgeon with information in the context of nerve trauma, entrapment, and nerve involvement by tumors. Peripheral neuropathy about the knee can occur in the context of associated knee pathology such as trauma, as part of a systemic disease, or as an isolated finding...
April 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/28339447/chronic-localized-back-pain-due-to-posterior-cutaneous-nerve-entrapment-syndrome-pocnes-a-new-diagnosis
#7
Oliver B Boelens, Robert C Maatman, Marc R Scheltinga, Kees van Laarhoven, Rudi M Roumen
Most patients with chronic back pain suffer from degenerative thoracolumbovertebral disease. However, the following case illustrates that a localized peripheral nerve entrapment must be considered in the differential diagnosis of chronic back pain. We report the case of a 26-year-old woman with continuous excruciating pain in the lower back area. Previous treatment for nephroptosis was to no avail. On physical examination the pain was present in a 2 x 2 cm area overlying the twelfth rib some 4 cm lateral to the spinal process...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28334999/rewiring-the-primary-somatosensory-cortex-in-carpal-tunnel-syndrome-with-acupuncture
#8
RANDOMIZED CONTROLLED TRIAL
Yumi Maeda, Hyungjun Kim, Norman Kettner, Jieun Kim, Stephen Cina, Cristina Malatesta, Jessica Gerber, Claire McManus, Rebecca Ong-Sutherland, Pia Mezzacappa, Alexandra Libby, Ishtiaq Mawla, Leslie R Morse, Ted J Kaptchuk, Joseph Audette, Vitaly Napadow
Carpal tunnel syndrome is the most common entrapment neuropathy, affecting the median nerve at the wrist. Acupuncture is a minimally-invasive and conservative therapeutic option, and while rooted in a complex practice ritual, acupuncture overlaps significantly with many conventional peripherally-focused neuromodulatory therapies. However, the neurophysiological mechanisms by which acupuncture impacts accepted subjective/psychological and objective/physiological outcomes are not well understood. Eligible patients (n = 80, 65 female, age: 49...
April 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28303912/new-technologies-for-the-assessment-of-neuropathies
#9
REVIEW
Roberto Gasparotti, Luca Padua, Chiara Briani, Giuseppe Lauria
Technical advances are rapidly changing the clinical and instrumental approach to peripheral nerve diseases. Magnetic resonance neurography, diffusion tensor imaging and nerve ultrasonography are increasingly entering the diagnostic workup of peripheral neuropathies as tools that complement neurophysiology and enable investigation of proximal structures, such as plexuses and roots. Progress in the design of magnetic resonance scanners and sequences, and the development of high-frequency ultrasound probes mean that high-resolution peripheral nerve imaging is possible, enabling detailed examination of nerve size, morphology and internal fascicular structure that can integrate nerve conduction studies into clinical practice...
March 17, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28226286/peripheral-nerve-ultrasonography-in-patients-with-transthyretin-amyloidosis
#10
Simon Podnar, Stayko Sarafov, Ivailo Tournev, Gregor Omejec, Janez Zidar
OBJECTIVE: To systematically study peripheral nerve morphology in patients with transthyretin (TTR) amyloidosis and TTR gene mutation carriers using high-resolution ultrasonography (US). METHODS: In this prospective cross-sectional study we took a structured history, performed neurological examination, and measured peripheral nerve cross-sectional areas (CSAs) bilaterally at 28 standard locations using US. Demographic and US findings were compared to controls. RESULTS: Peripheral nerve CSAs were significantly larger in 33 patients with familial amyloid polyneuropathy (FAP) compared to 50 controls, most dramatically at the common entrapment sites (median nerve at the wrist, ulnar nerve at the elbow), and in the proximal nerve segments (median nerve in the upper arm, sciatic nerve in the thigh)...
April 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28220607/neurological-and-spinal-manifestations-of-the-ehlers-danlos-syndromes
#11
Fraser C Henderson, Claudiu Austin, Edward Benzel, Paolo Bolognese, Richard Ellenbogen, Clair A Francomano, Candace Ireton, Petra Klinge, Myles Koby, Donlin Long, Sunil Patel, Eric L Singman, Nicol C Voermans
The Ehlers-Danlos syndromes (EDS) are a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin extensibility, and tissue fragility. This communication briefly reports upon the neurological manifestations that arise including the weakness of the ligaments of the craniocervical junction and spine, early disc degeneration, and the weakness of the epineurium and perineurium surrounding peripheral nerves. Entrapment, deformation, and biophysical deformative stresses exerted upon the nervous system may alter gene expression, neuronal function and phenotypic expression...
February 21, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28188345/-diagnostic-nerve-ultrasonography
#12
T Bäumer, A Grimm, T Schelle
CLINICAL/METHODICAL ISSUE: For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. STANDARD RADIOLOGICAL METHODS: Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method...
February 10, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28124109/decompression-endoscopic-surgery-for-frontal-secondary-headache-attributed-to-supraorbital-and-supratrochlear-nerve-entrapment-a-comprehensive-review
#13
REVIEW
Boris Filipović, J Alexander de Ru, Rick van de Langenberg, Pepijn A Borggreven, Zdravko Lacković, Peter J F M Lohuis
In the last decade, a new surgical treatment modality was developed for frontal secondary headache, based on the assumption that the trigger of this pain entity is the entrapment of peripheral sensory nerves. The surgery entails a procedure, where an endoscopic approach is used to decompress the supraorbital and supratrochlear nerve branches, which are entrapped by the periosteum in the region of the corrugator supercilii muscle. Candidates for the surgery define their headache as moderate to severe persistent daily pressure or tension, localized in the frontal area, sometimes accompanied by symptoms of nausea and photophobia mimicking a primary headache-migraine...
January 25, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28038479/acute-improvement-in-intraoperative-emg-following-common-fibular-nerve-decompression-in-patients-with-symptomatic-diabetic-sensorimotor-peripheral-neuropathy-1-emg-results
#14
James C Anderson, D Scott Nickerson, Brian L Tracy, Roger J Paxton, Dwayne S Yamasaki
Background and Study Aims Electromyographic (EMG) recordings of the fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during common fibular nerve (CFN) nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27989968/superior-cluneal-nerve-entrapment-neuropathy-and-gluteus-medius-muscle-pain-their-effect-on-very-old-patients-with-low-back-pain
#15
Rinko Kokubo, Kyongsong Kim, Toyohiko Isu, Daijiro Morimoto, Naotaka Iwamoto, Shiro Kobayashi, Akio Morita
OBJECTIVE: In the very elderly, their general condition and poor compliance with drug regimens can render the treatment of low back pain (LBP) difficult. We report the effectiveness of a less-invasive treatment for intractable LBP from superior cluneal nerve entrapment neuropathy (SCN-EN) and gluteus medius muscle (GMeM) pain. PATIENTS AND METHODS: Between April 2013 and March 2015, we treated 17 consecutive elders with LBP, buttock pain, and leg pain. They were 4 men and 13 women ranging in age from 85 to 91 years (mean 86...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27915068/effects-of-pulsed-ultrasound-therapy-on-sensory-nerve-conduction-parameters-and-the-pain-threshold-perceptions-in-humans
#16
Othmar Schuhfried, Damir Vukanovic, Christian Kollmann, Karin Pieber, Tatjana Paternostro-Sluga
BACKGROUND: Therapeutic ultrasound is an often-used clinical modality in the nonsurgical treatment of entrapment neuropathies. To date, the possible mechanism of action of pulsed ultrasound therapy on the peripheral nerve in the treatment of entrapment neuropathies is unclear. OBJECTIVE: To examine the effects of pulsed ultrasound therapy on peripheral nerve conduction parameters. DESIGN: A prospective, randomized, single blind, crossover study...
November 30, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27906945/ganglion-cyst-at-the-proximal-tibiofibular-joint-in-a-patient-with-painless-foot-drop
#17
Abdulmuhsen Alsahhaf, Waleed Renno
Entrapment neuropathies of the fibular nerve and its branches are often underdiagnosed due to the lack of reliable diagnosis using clinical examination and electrophysiologic evaluation. Most fibular nerve compressions may be classified into 2 broad categories: (a) mechanical causes, which occur at fibrous or fibro-osseous tunnels, and (b) dynamic causes related to nerve injury during specific limb positioning. Foot drop resulting from weakness of the dorsiflexor muscles of the foot is a relatively uncommon presentation and closely related to L5 neuropathy caused by a disc herniation...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27902538/ulnar-tunnel-syndrome-radial-tunnel-syndrome-anterior-interosseous-nerve-syndrome-and-pronator-syndrome
#18
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27875620/a-reliable-technique-for-ultrasound-guided-perineural-injection-in-ulnar-neuropathy-at-the-elbow
#19
Ulrike M Hamscha, Ines Tinhofer, Stefan Heber, Wolfgang Grisold, Wolfgang J Weninger, Stefan Meng
INTRODUCTION: Ulnar neuropathy at the elbow (UNE) is a common peripheral compression neuropathy and, in most cases, occurs at 2 sites, the retroepicondylar groove or the cubital tunnel. With regard to a potential therapeutic approach with perineural corticosteroid injection, the aim of this study was to evaluate the distribution of injection fluid applied at a standard site. METHODS: We performed ultrasound-guided (US-guided) perineural injections to the ulnar nerve halfway between the olecranon and the medial epicondyle in 21 upper limbs from 11 non-embalmed cadavers...
November 22, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27861415/decompressive-surgery-for-diabetic-neuropathy-waiting-for-incontrovertible-proof
#20
Martijn R Tannemaat, Mirjam Datema, J Gert van Dijk, Rajiv Midha, Martijn J A Malessy
: Triple decompression surgery has been advocated as a treatment for diabetic peripheral neuropathy (DPN). A practice advisory published in 2006 by the American Academy of Neurology concluded that "this treatment alternative should be considered unproven." Since then, multiple cohort studies involving several thousands of patients and 1 nonblind, randomized, controlled trial have been published, suggesting that surgical treatment of DPN has become commonplace in many centers globally. The results of these observational studies suggest that decompressive surgery could result in a substantial reduction of pain and the restoration of sensation in patients with DPN...
December 2016: Neurosurgery
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