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Peripheral nerve entrapment

Sang Hyun Nam, Jung Yeon Kim, Jaeki Ahn, Yongbum Park
Plexiform neurofibromas of the foot are rare, benign tumors of the peripheral nerves. Diagnosis can be challenging if they present with symptoms mimicking other peripheral nerve pathologies. Tarsal tunnel syndrome is an entrapment syndrome of the entire tibial nerve behind the medial malleolus and under the flexor retinaculum. The clinical presentation typically includes posteromedial pain, positive Tinel's sign, and neurogenic signs, including both the sensation of numbness and the actual hypoesthesia and clawing of the toes...
January 2018: The surgery journal
Seyed Ahmad Raeissadat, Afshin Karimzadeh, Masoud Hashemi, Leila Bagherzadeh
BACKGROUND: Carpal tunnel syndrome is the most common peripheral entrapment neuropathy, for which conservative treatments are the first measures taken. However, these measures are not usually sufficient. Recently major attention has been drawn to platelet-rich plasma for its possible effects on axon regeneration and neurological recovery. Although few studies have evaluated the effects of this treatment in carpal tunnel syndrome, further investigation is required to reach concrete conclusion...
February 13, 2018: BMC Musculoskeletal Disorders
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Kazuyoshi Yamazaki, Daijiro Morimoto, Masanori Isobe
INTRODUCTION: Some patients suffer failed back surgery syndrome (FBSS) after lumbar spine surgery. We report the effect of additional treatments for para-lumbar- and peripheral nerve diseases addressing residual symptoms after lumbar spine surgery. MATERIALS AND METHODS: We enrolled 74 patients (59 men and 15 women, mean age 62.9 years) who had undergone lumbar posterior decompression surgery in our department. Mean follow-up after initial lumbar surgery was 26...
January 31, 2018: World Neurosurgery
Jonathan J Crook, Charly Brouillard, Pedro Irazoqui, Thelma Lovick
Objective Neuromodulation of autonomic nerve activity to regulate physiological processes is an emerging field. Vagal stimulation has received most attention whereas the potential of modulate visceral function by targeting autonomic nerves within the abdominal cavity remains under-exploited. Surgery to locate intra-abdominal targets is inherently more stressful than for peripheral nerves. Electrode leads risk becoming entrapped by intestines and loss of functionality in the nerve-target organ connection could result from electrode migration or twisting...
January 5, 2018: Journal of Neural Engineering
Robert J Spinner, Holly S Gilmer, Gregory R Trost
If a single picture is worth a thousand words, then a video, by logical extension, would be priceless. This edition showcases peripheral nerve surgery in all its grandeur and preserves it for posterity. Classic and novel surgical techniques are shown related to tumor biopsy or resection; nerve decompression for entrapment; and nerve reconstruction with direct repair or nerve transfer. Akin to a nautical chart filled with detailed maps for sailors, this Neurosurgical Focus Video Atlas provides navigational tools for neurosurgeons...
January 2018: Neurosurgical Focus
Edie Benedito Caetano, João José Sabongi Neto, Lucas Augusto Ayres Ribas, Edson Vinícius Milanello
Anatomical variations of the flexor digitorum superficialis (FDS) muscle and tendon unit are frequently reported by anatomists and clinicians. Anatomical muscle variations of the FDS and its tendons may include variations of muscle belly, presence of accessory or duplicate tendons, abnormal tendon connections, and absence of muscle or tendon components. Such variations may or may not have clinical implications. This report presents a case not described previously: a unilateral accessory muscle of the flexor digitorum superficialis which was connected by a thick tendon to the flexor digitorum superficialis muscle; it was directed proximally to the insertion of the medial epicondyle of the humerus, next to the superficialis head of the pronator teres muscle...
November 2017: Revista Brasileira de Ortopedia
RobRoy Martin, Hal David Martin, Benjamin R Kivlan
The purpose of this clinical commentary is to review the anatomy, etiology, evaluation, and treatment techniques for nerve entrapments of the hip region. Nerve entrapment can occur around musculotendinous, osseous, and ligamentous structures because of the potential for increased strain and compression on the peripheral nerve at those sites. The sequela of localized trauma may also result in nerve entrapment if normal nerve gliding is prevented. Nerve entrapment can be difficult to diagnose because patient complaints may be similar to and coexist with other musculoskeletal conditions in the hip and pelvic region...
December 2017: International Journal of Sports Physical Therapy
Eoin Mulroy, Andrew M Chancellor, Luciana Pelosi
PURPOSE: The mucolipidoses are rare autosomal recessive lysosomal storage disorders. Neurologic involvement in these conditions is generally thought to be limited to cognitive delay and entrapment neuropathies (primarily carpal tunnel syndrome). We sought to evaluate peripheral nerves in this condition using nerve ultrasound. METHODS: We performed peripheral nerve ultrasound in two siblings with genetically confirmed mucolipidosis type 3 (alpha/beta). RESULTS: Peripheral nerves in mucolipidosis type 3 (alpha/beta) exhibit multifocal enlargement...
February 2018: Neuroradiology
Kolawole Wasiu Wahab, Emmanuel O Sanya, Philip B Adebayo, Musbaudeen O Babalola, Hakeem G Ibraheem
Entrapment neuropathy is the result of pressure on a peripheral nerve as it passes through a narrow canal that is bounded by stiff tissues. In spite of their ubiquitous nature, they are underdiagnosed, underreported, and sometimes not properly managed, especially in developing countries. Entrapment neuropathies are of various types, but the most common type is carpal tunnel syndrome. Mechanisms involved in the pathophysiology of entrapment neuropathies include mechanical compression and nerve ischemia. A clear understanding of the various types and the underlying mechanisms of entrapment neuropathies are invaluable in the decision-making process involved in the management of every patient with the condition...
November 2017: Oman Medical Journal
Angela Burian, Othmar Schuhfried, Richard Crevenna
PURPOSE: To describe the clinical manifestation and the treatment of complex regional pain syndrome type II in childhood. METHODS: Using information on the symptoms, diagnosis, rehabilitation and outcome of a young patient with complex regional pain syndrome type II. RESULTS: A 9-year -old girl had severe pain in the region of the left foot, signs of a common fibular nerve entrapment, hyperalgesia not limited to the distribution of the injured nerve, weakness and temperature asymmetry unknown origin...
December 7, 2017: Disability and Rehabilitation
Beatriz Mansilla, Alberto Isla, María Román de Aragón, Borja Hernández, Pablo García Feijoo, Alexis Palpán Flores, Susana Santiago
OBJECTIVE: Intraneural cysts are benign lesions located within the epineurium of some peripheral nerves and their aetiopathogenesis is controversial. Most are located at the level of the lower limbs. In the upper limbs, the most frequently affected nerve is the ulnar nerve. Suprascapular nerve entrapment syndrome due to the formation of an intraneural cyst is rare. In this article, we show a new case and perform a literature review of intraneural cysts located in the suprascapular nerve...
November 20, 2017: Neurocirugía
Bhagavatula Indira Devi, Subhas K Konar, Dhananjaya I Bhat, Dhaval P Shukla, R Bharath, M S Gopalakrishnan
AIM: This study was undertaken to address the epidemiological characteristics, operative details, and surgical outcome of peripheral nerve injuries in children treated in a tertiary hospital in India (NIMHANS, Bangalore). MATERIALS AND METHODS: This is a retrospective study of epidemiology, operative findings, and surgical outcomes over the period of 2000-2016. Our series includes 102 children with peripheral nerve injuries of various causes. RESULTS: Intramuscular injections were the most common cause (52...
November 23, 2017: Pediatric Neurosurgery
Tord D Alden, Hernán Amartino, Amauri Dalla Corte, Christina Lampe, Paul R Harmatz, Leonardo Vedolin
The mucopolysaccharidosis (MPS) disorders are ultra-rare lysosomal storage disorders associated with progressive accumulation of glycosaminoglycans (GAGs) in cells and tissues throughout the body. Clinical manifestations and progression rates vary widely across and within the different types of MPS. Neurological symptoms occur frequently, and may result directly from brain damage caused by infiltration of GAGs, or develop secondary to somatic manifestations such as spinal cord compression, hydrocephalus, and peripheral nerve entrapment...
December 2017: Molecular Genetics and Metabolism
Gian Maria Fabrizi, Stefano Tamburin, Tiziana Cavallaro, Ilaria Cabrini, Moreno Ferrarini, Federica Taioli, Francesca Magrinelli, Giampietro Zanette
OBJECTIVE: Nerve ultrasound (US) data on myelin protein zero (MPZ)-related Charcot-Marie-Tooth disease (CMT) are lacking. To offer a comprehensive perspective on MPZ-related CMTs, we combined nerve US with clinics, electrodiagnosis and histopathology. METHODS: We recruited 36 patients (12 MPZ mutations), and correlated nerve US to clinical, electrodiagnostic measures, and sural nerve biopsy. RESULTS: According to motor nerve conduction velocity (MNCV) criteria, nine patients were categorized as "demyelinating" CMT1B, 17 as "axonal" CMT2I/J, and 10 as dominant "intermediate" CMTDID...
October 20, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Ben Kasehagen, Richard Ellis, Rodney Pope, Nicholas Russell, Wayne Hing
Ultrasound imaging (USI) is gaining popularity as a tool for assessing nerve excursion and is becoming an important tool for the assessment and management of entrapment neuropathies. This systematic review aimed to identify current methods and report on the reliability of using USI to examine nerve excursion and identify the level of evidence supporting the reliability of this technique. A systematic search of five electronic databases identified studies assessing the reliability of using USI to examine nerve excursion...
January 2018: Ultrasound in Medicine & Biology
Tina Jeon, Maggie M Fung, Kevin M Koch, Ek T Tan, Darryl B Sneag
Diffusion tensor imaging (DTI) is a noninvasive magnetic resonance imaging (MRI) technique that measures the extent of restricted water diffusion and anisotropy in biological tissue. Although DTI has been widely applied in the brain, more recently researchers have used it to characterize nerve pathology in the setting of entrapment neuropathy, traumatic injury, and tumor. DTI artifacts are exacerbated when imaging off isocenter in the body. Anecdotally, the most significant artifacts in peripheral nerve DTI include magnetic field inhomogeneity, motion, incomplete fat suppression, aliasing, and distortion...
October 30, 2017: Journal of Magnetic Resonance Imaging: JMRI
Nicola Buono, Hans Thulesius, Ferdinando Petrazzuoli, Elena Castelli, Marco Cambielli
INTRODUCTION: Chronic peripheral neuropathic pain (CPNP) is a condition due to peripheral nervous system diseases or injury, but its prevalence is unknown in Italian primary care. AIM: The aim of this study is to assess the prevalence of CPNP in a rural primary care area in Northern Italy. MATERIALS AND METHODS: A multicenter audit study was carried out in a rural area in Northern Italy with 113 participating general practitioners (GPs) seeing 58,480 patients >18 years during 3 months...
January 2017: Journal of Family Medicine and Primary Care
Ian M Foran, Vincent Hussey, Rushil A Patel, Jaemyoung Sung, Sameer B Shah
Paraneurial adhesions have been implicated in the pathological progression of entrapment neuropathies. Surgical decompression of adhesions is often performed, with the intent of restoring nerve kinematics. The normal counterpart of adhesions, native paraneurium, is also thought to influence nerve deformation and mobility. However, influences of native or abnormal paraneurial structures on nerve kinematics have not been investigated. We measured regional strains in rat sciatic nerves before and immediately after decompression of native paraneurial tissue, and before and after decompression of abnormal paraneurial adhesions, which formed within 6 weeks of the initial decompression...
January 1, 2017: Journal of Hand Surgery, European Volume
Shehzad Khalid, Joe Iwanaga, Marios Loukas, R Shane Tubbs
Leg pain from lumbar disc herniation is a common presentation. However, certain muscular and peripheral nerve variants may present similarly and represent an unrecognized etiology of femoral nerve dysfunction. Such cases might affect the outcome of specific treatment regimes. Therefore, recognition of these variations in anatomy may be useful to the clinician when treating the patient with medically refractory lower limb pain. Some reports have reported variant slips of the psoas and iliacus muscles, which may split the femoral nerve causing a potential risk for nerve entrapment...
August 9, 2017: Curēus
Aniek Pm van Zantvoort, Paul Cuppen, Marc R Scheltinga
The differential diagnosis of exercise-induced lower leg pain in young individuals is extensive and includes entities such as chronic exertional compartment syndrome, popliteal arterial entrapment syndrome, cystic adventitial disease, medial tibial stress syndrome and tibial stress fractures. Peripheral nerve-related lower leg pain syndromes are unusual. We present a 41-year-old woman who was diagnosed with an ancient schwannoma of the right common peroneal nerve (CPN) as a rare cause of lower leg pain. This case report provides simple diagnostic bedside tools that may be used to diagnose CPN abnormalities...
October 4, 2017: BMJ Case Reports
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