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Median nerve

M Arnal, A Cambon, P-S Marcheix, Z Belkhayar
Consensus opinion is that active movement of the elbow is a priority in the surgical treatment of total brachial plexus injuries. But the indications and neurotization techniques used to restore motor function of the hand are the subject of discussion. The aim of this retrospective study was to evaluate, in adult patients with complete post-traumatic paralysis of the brachial plexus, the functional results of neurotization of four intercostal nerves on the musculocutaneous nerve and grafting of the C5 root by one strand on the nerve to the long head of triceps and three strands on the medial component of the median nerve...
September 2016: Hand Surgery and Rehabilitation
J-N Goubier, F Teboul
Recovery of shoulder function is a real challenge in cases of partial brachial plexus palsy. Currently, in C5-C6 root injuries, transfer of the long head of the triceps brachii branch is done to revive the deltoid muscle. Spinal accessory nerve transfer is typically used for reanimation of the suprascapular nerve. We propose an alternative technique in which the nerve of the rhomboid muscles is transferred to the suprascapular nerve. A 33-year-old male patient with a C5-C6 brachial plexus injury with shoulder and elbow flexion palsy underwent surgery 7 months after the injury...
October 2016: Hand Surgery and Rehabilitation
Tal Hoffmann, Katrin Kistner, Richard W Carr, Mohammed A Nassar, Peter W Reeh, Christian Weidner
The upregulation of the tetrodotoxin-resistant voltage-gated sodium channel NaV1.9 has previously been associated with inflammatory hyperalgesia. Na1.9 knockout (KO) mice, however, did not seem insensitive in conventional tests of acute nociception. Using electrophysiological, neurochemical, and behavioral techniques, we now show NaV1.9-null mice exhibit impaired mechanical and thermal sensory capacities and reduced electrical excitability of nociceptors. In single-fiber recordings from isolated skin, the electrical threshold of NaV1...
September 15, 2016: Pain
T Wiesmann, T Steinfeldt, M Exner, W Nimphius, J De Andres, H Wulf, U Schwemmer
BACKGROUND & OBJECTIVES: Most anesthesiologists use the injection of a test dose of local anesthetic in order to evaluate the final needle tip position. Thus, the intraneural injection of a full dose can be avoided. The aim of this study was to analyze whether an intraneural injection of a test dose of bupivacaine could trigger histological changes. METHODS: Intraneural injections under direct vision were performed in 40 brachial plexus nerves in seven anesthetized pigs...
October 25, 2016: Acta Anaesthesiologica Scandinavica
Anna C Lawson McLean, Steffen K Rosahl
OBJECT: Neurofibromatosis type 2 is an autosomal-dominant disorder caused by a defective gene locus 22q12. Patients with NF2 are prone to develop multiple intracranial neoplasms, such as vestibular schwannomas, meningiomas and schwannomas of other cranial nerves. To date, little is known about the growth dynamics of these tumors. The aim of our study was to investigate a) the median growth rate per year, b) the growth-free intervals, and c) the growth patterns of these tumors. METHODS: Patient records from the regional neurofibromatosis center were evaluated for their suitability in this analysis...
October 21, 2016: World Neurosurgery
Michele Bailo, Nicola Boari, Filippo Gagliardi, Alberto Franzin, Martina Piloni, Alfio Spina, Marco Gemma, Antonella Del Vecchio, Angelo Bolognesi, Pietro Mortini
OBJECT: Complete vestibular schwannomas (VS) removal is not always achievable without any risk of disabling postoperative complications, especially in terms of facial nerve function. Moreover, even after gross total removal a relevant rate of recurrence has been reported. The aim of this study is to validate Gamma Knife radiosurgery (GKRS) as an effective strategy to treat tumor's regrowth after previous surgery. METHODS: Ninety patients treated with GKRS for VS after previous microsurgery were included in the present study...
October 21, 2016: World Neurosurgery
Dallas M Smuin, William L Hennrikus
BACKGROUND: The pucker sign, also called skin tenting, indicates significant displacement of the supracondylar fracture and can be a cause for alarm. The purpose of this study is to compare a cohort of patients with type III supracondylar fractures presenting with a pucker sign to a group without a pucker sign by evaluating neurovascular injury at presentation, need for open reduction, persistent neurovascular injury, range of motion, and carrying angle at final follow-up. METHODS: A retrospective review was performed for Gartland type III extension type supracondylar fractures...
October 21, 2016: Journal of Pediatric Orthopedics
Karan Dua, Timothy P Lancaster, Joshua M Abzug
BACKGROUND: Objective sensory testing is a critical component of the physical examination in children as they may be unable to communicate whether or not numbness is present. The purpose of this study was to determine at what age objective sensory tests could reliably be performed. METHODS: Normal, uninjured participants aged 2 to 17 years were enrolled in the study. Monofilament and static/moving 2-point discrimination tests were performed bilaterally assessing the median, ulnar, and radial nerves...
October 21, 2016: Journal of Pediatric Orthopedics
Cristóbal Couto, Ariel Schlaen, Mercedes Frick, Marina Khoury, Matilde Lopez, Erika Hurtado, Debra Goldstein
PURPOSE: To evaluate the clinical outcome and safety of adalimumab in patients with Vogt-Koyanagi-Harada (VKH) disease. METHODS: VKH patients treated with adalimumab seen at the University of Buenos Aires were reviewed. Main outcome measures were visual acuity, anterior segment inflammation, optic nerve inflammation (ONI), steroid sparing effect, number of immunosuppressives, and relapses. RESULTS: In total, 14 VKH patients, mean age 23.07 ± 8 years; median of adalimumab treatment 10 months, were analyzed...
October 24, 2016: Ocular Immunology and Inflammation
Ugur Uygunoglu, Aysegul Gunduz, Harika Devrimsel Ertem, Derya Uluduz, Sabahattin Saip, Baki Goksan, Aksel Siva, Nurten Uzun, Feray Karaali-Savrun, Meral Kızıltan
OBJECTIVE: Prepulse inhibition (PPI) of the blink reflex (BR) is a reduction in BR excitability due to a conditioning stimulus, reflecting sensory gating by brainstem structures. We aimed to analyze PPI changes during a painful episode in chronic or episodic migraine and its relation to allodynia, since abnormal brainstem filtering has been hypothesized in migraine pathophysiology. METHODS: We included 20 patients with migraine during headache episode, and age- and gender-matched 22 healthy subjects...
October 19, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
H Bao, C Wu, S Wang, G Wang, X Zhang, X Zhang, L Wu
AIM: To investigate the applicability of diffusion-weighted magnetic resonance neurography (DW-MRN) in the diagnosis of carpal tunnel syndrome (CTS). MATERIALS AND METHODS: In total, 47 patients with CTS (69 wrists) and 19 normal participants (38 wrists) was included in this study. Cross-sectional area (CSA) and apparent diffusion coefficient (ADC) values of the median nerves in the carpal tunnel were determined using DW-MRN. Receiver operating characteristic (ROC) analysis was performed...
October 19, 2016: Clinical Radiology
C Nos, K B Clough, P Bonnier, S Lasry, G Le Bouedec, B Flipo, J-M Classe, M-C Missana, V Doridot, S Giard, H Charitansky, A Charles-Nelson, A-S Bats, C Ngo
BACKGROUND: Two thirds of node-positive breast cancer patients have limited pN1 disease and could benefit from a less extensive axillary lymph node dissection (ALND). METHODS: 172 breast cancers patients requiring an ALND were prospectively enrolled in the Sentibras Protocol of Axillary Reverse Mapping (ARM). Radioisotope was injected in the ipsilateral hand the day before surgery. ALND was standard. Removed lymph nodes were classified into non radioactive nodes and radioactive nodes (ARM nodes)...
August 26, 2016: European Journal of Surgical Oncology
Mari Hayashi, Kento Shionoya, Shogo Hayashi, Naoyuki Hatayama, Shinichi Kawata, Ning Qu, Shuichi Hirai, Hidenobu Miyaso, Masahiro Itoh
The musculocutaneous nerve innervates the brachial flexors; i.e., the coracobrachialis, biceps brachii, and brachialis. The musculocutaneous and median nerve sometimes share a communicating branch and also muscular branches to brachial flexors are sometimes transposed to median nerve. Because these variations constitute a potentially important clinical and surgical issue, we evaluated 130 upper limbs of 65 cadavers and 184 cases of musculocutaneous and median nerve variations in the literature and devised a novel system of classification that covers each pattern of variation...
October 17, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Paulo José Lorenzoni, Cláudia Suemi Kamoi Kay, Cristiane Cavalet, Raquel C Arndt, Lineu Cesar Werneck, Rosana Herminia Scola
The spectrum of clinical and electrophysiological features in hereditary neuropathy with liability to pressure palsies (HNPP) is broad. We analyze a series of Brazilian patients with HNPP. Correlations between clinical manifestations, laboratory features, electrophysiological analyze, histological and molecular findings were done. In five cases, more than one episode occurred before diagnosis. Median nerve in the carpal tunnel at the wrist, ulnar nerve in its groove at the elbow, fibular nerve in the head of the fibula at the knee, radial nerve in its groove of the humerus and suprascapular nerve in its notch at the supraspinous fossa were found as focal neuropathies...
September 30, 2016: Neurology International
Giampietro Zanette, Matteo F Lauriola, Stefano Tamburin
INTRODUCTION: The authors have recently tested a new electrodiagnostic technique for palmar proper digital nerves sensory nerve action potentials in normal controls. Here the authors explored whether it may offer additional information in comparison to mixed nerve wrist stimulation in a series of patients. METHODS: The authors recorded palmar proper digital nerves sensory nerve action potential to selective antidromic webspace stimulation in a group of 19 patients with suspected lesions of median and ulnar nerve hand sensory branches...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Alon Abraham, Aaron Izenberg, Dubravka Dodig, Vera Bril, Ari Breiner
INTRODUCTION: Neuralgic amyotrophy (NA) is characterized by acute or subacute onset of shoulder and arm pain, followed by muscle atrophy and weakness, and variable sensory abnormalities. Historically, the site of inflammation has been localized to the brachial plexus, although involvement of individual nerve branches has been well recognized. METHODS: We describe ultrasound (US) findings in 2 cases with clinical presentation suggestive for NA, involving individual peripheral nerves, correlating with clinical and electrophysiological findings...
June 13, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Volkan Solmaz, Selçuk Yavuz, Ahmet İnanr, Dürdane Aksoy, Elmas Pektaş, Aslan Tekataş, Semiha Gulsum Kurt
INTRODUCTION: our aim was to determine if there are electro diagnostic (EDX) differences between carpal tunnel syndrome (CTS) patients with diabetes mellitus (DM), CTS+hypothyroidism (HT), CTS+fibromyalgia (FMS), CTS+rheumatoid arthritis (RA), and idiopathic CTS cases by comparing nerve conduction studies (NCS). METHOD: This research examined electrophysiological studies of untreated 47 HT+CTS, 47 DM+CTS, 49 RA+CTS, 52 FMS+CTS, 50 idiopathic CTS cases, and a healthy control group of 50 individuals (total of 293 patients and 433 hands with CTS)...
October 6, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Myreille D'Astous, Allen L Ho, Arjun Pendharkar, Clara Y H Choi, Scott G Soltys, Iris C Gibbs, Armine T Tayag, Patricia A Thompson, John R Adler, Steven D Chang
Non-vestibular cranial nerve schwannomas (NVCNS) are rare lesions, representing <10 % of cranial nerve schwannomas. The optimal treatment for NVCNS is often derived from vestibular schwannomas experience. Surgical resection has been referred to as the first line treatment for those benign tumors, but significant complication rates are reported. Stereotactic radiosurgery (SRS) has arisen as a mainstay of treatment for many benign tumors, including schwanommas. We retrospectively reviewed the outcomes of NVCNS treated by SRS to characterize tumor control, symptom relief, toxicity, and the role of hypo-fractionation of SRS dose...
October 17, 2016: Journal of Neuro-oncology
Yusuf A Rajabally, Fu Liong Hiew
INTRODUCTION: The most efficient method of performing electrophysiology for Guillain-Barré syndrome (GBS) is unknown. METHODS: We retrospectively analyzed electrophysiological data of 97 consecutive GBS patients from Birmingham, U.K. (2001-12) studied ≤3 weeks post-onset. RESULTS: The sensitivity of electrophysiology for each GBS subtype was dependent on the tested upper and lower limb nerves. In acute inflammatory demyelinating polyneuropathy (AIDP), abnormalities were predominant in the arms, whereas leg abnormalities predominated in axonal GBS...
October 17, 2016: Muscle & Nerve
Andrea Streng, Veit Grote, Anita Rack-Hoch, Johannes G Liese
BACKGROUND: Universal varicella vaccination for one-year-old children was introduced in Germany in 2004. We investigated changes in incidence and type of varicella-associated neurologic complications in children during the first 7 years after universal vaccination recommendation. METHODS: Surveillance study based on patients <17 years of age with an International Classification of Diseases (10 Revision, ICD-10) discharge diagnosis of varicella, annually reported by 22-29 pediatric hospitals in Bavaria (Germany), 2005 to 2011...
October 3, 2016: Pediatric Infectious Disease Journal
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