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Entrapment Syndromes

Luca Padua, Daniele Coraci, Carmen Erra, Costanza Pazzaglia, Ilaria Paolasso, Claudia Loreti, Pietro Caliandro, Lisa D Hobson-Webb
Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome worldwide. The clinical symptoms and physical examination findings in patients with this syndrome are recognised widely and various treatments exist, including non-surgical and surgical options. Despite these advantages, there is a paucity of evidence about the best approaches for assessment of carpal tunnel syndrome and to guide treatment decisions. More objective methods for assessment, including electrodiagnostic testing and nerve imaging, provide additional information about the extent of axonal involvement and structural change, but their exact benefit to patients is unknown...
November 2016: Lancet Neurology
Yi-Ming Ren, Xi-Shan Wang, Zhi-Jian Wei, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Shi-Qing Feng
BACKGROUND: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disease. Either surgical or conservative intervention for CTS patients is needed to choose. We conducted this systematic review and meta-analysis to compare the clinical efficacy, safety, and cost of surgical versus nonsurgical intervention. METHODS: The eligible studies were acquired from PubMed, Medline, Embase, Web of Science, Google, and Cochrane Library. The data were extracted by 2 of the coauthors independently and were analyzed by RevMan5...
October 2016: Medicine (Baltimore)
O Herisson, M Dury, E Rapp, F Marin-Braun
Carpal tunnel syndrome is the most common entrapment syndrome. The incidence of a bilateral condition varies between 22% and 87%. The aim of our study was to assess the level of satisfaction and the clinical outcomes in a group of patients operated on through a bilateral neurolysis on the median nerve in the carpal tunnel, in one operating session. This is a retrospective study involving patients with an electromyographic and clinical diagnosis of bilateral carpal tunnel syndrome. Patients were treated on an outpatient basis and the bilateral neurolysis was performed by endoscopy...
June 2016: Hand Surgery and Rehabilitation
J Laulan
Neurogenic thoracic outlet syndrome (TOS) is one of the most controversial pain syndromes of the upper limbs. The controversies revolve around both the diagnosis and treatment of the non-specific or subjective subtypes. Their diagnosis rests on a combination of history, suggestive symptoms and clinical examination. Proximal pain is primarily muscular in origin, while distal symptoms may be the result of intermittent nerve compression and/or myofascial pain syndrome. Stringent clinical criteria are required to confirm the diagnosis of subjective TOS...
June 2016: Hand Surgery and Rehabilitation
Ichiro Kawahara, Keisuke Ozono, Takashi Fujimoto, Makoto Hirose
Eagle syndrome is a well-known disease caused by elongation of the styloid process and/or calcification of the stylohyoid ligament, which interferes with adjacent anatomical structures, giving rise to acute cerebrovascular syndrome(ACVS)and/or pain. Although hyoid bone is also a stylohyoid complex, its association with ACVS is not well known. Thus, we investigated the anatomical relationship between the internal carotid artery(ICA)and the hyoid bone. Between January 2014 and December 2015, three-dimensional computed tomographic angiography(3D-CTA)of the neck was performed for 218 patients...
October 2016: No Shinkei Geka. Neurological Surgery
Ilya Igolnikov, Matthew J Santiago, Kathryn T Gollotto
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Figen Taser, Ayse Nur Deger, Hakkı Deger
AIM: Current study planned to investigate histologic findings and differences in carpal tunnel syndrome (CTS) with diabetes mellitus, thyroid disease and idiopathic CTS patients. MATERIAL AND METHODS: Subsynovial connective tissue samples of 51 idiopathic CTS patients, 58 patients with diabetes mellitus and CTS, 16 patients with hypothyroidism and CTS were evaluated for this study. The histopathologic examination parameters were number of fibroblasts, size of collagen fibers, vascular changes (vascular proliferation, intimal thickening and changes of vessel structures), edema and inflammatory infiltration...
May 5, 2016: Turkish Neurosurgery
Praveen Kumar Srikanteswara, Janardhan D Cheluvaiah, Jagadish B Agadi, Karthik Nagaraj
INTRODUCTION: Carpal Tunnel Syndrome (CTS) is the most common nerve entrapment. Subjective sensory symptoms are common place in patients with CTS, but sometimes they are not supported by objective findings in the neurological examination. Electrodiagnostic (EDx) studies are a valid and reliable means of confirming the diagnosis. The amplitudes along with the conduction velocities of the sensory nerve action potential and motor nerve action potential reflect the functional state of axons, and are useful parameters and complement the clinical grading in the assessment of severity of CTS...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Elizabeth M Pinder, Chye Yew Ng
The scratch collapse test (SCT) is a relatively new clinical test in which a positive result implies entrapment neuropathy of the nerve tested. Initially described for carpal and cubital tunnel syndromes, subsequent authors have found it useful for the assessment of median, ulna, radial, axillary, and common peroneal nerves. We report a case illustrating the value of the SCT in the clinical assessment of thoracic nerve entrapment.
August 2016: Journal of Hand and Microsurgery
Murid Siawash, Robbert Maatman, Walther Tjon A Ten, Ernst van Heurn, Rudi Roumen, Marc Scheltinga
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is a relatively unknown cause of severe neuralgic abdominal pain. Treatment includes medication, local nerve blocks or, if unresponsive, a neurectomy of nerve endings. In children, the outcome of neurectomy for ACNES is scantly described in retrospective studies. The objective of this first prospective study was to investigate the safety and short term success rate of anterior neurectomy in a large pediatric population with ACNES...
September 1, 2016: Journal of Pediatric Surgery
Vibhor Wadhwa, Kelly M Scott, Shai Rozen, Adam J Starr, Avneesh Chhabra
Chronic pelvic pain is a disabling condition that affects a large number of men and women. It may occur after a known inciting event, or it could be idiopathic. A common cause of pelvic pain syndrome is neuropathy of the pelvic nerves, including the femoral and genitofemoral nerves, ilioinguinal and iliohypogastric nerves, pudendal nerve, obturator nerve, lateral and posterior femoral cutaneous nerves, inferior cluneal nerves, inferior rectal nerve, sciatic nerve, superior gluteal nerve, and the spinal nerve roots...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Jae Wook Lee, Sung-Moon Lee, Dong Gyu Lee
Pudendal nerve entrapment syndrome is an unusual cause of chronic pelvic pain. We experienced a case of pudendal neuralgia associated with a ganglion cyst. A 60-year-old male patient with a tingling sensation and burning pain in the right buttock and perineal area visited our outpatient rehabilitation center. Pelvis magnetic resonance imaging showed the presence of multiple ganglion cysts around the right ischial spine and sacrospinous ligament, and the pudendal nerve and vessel bundle were located between the ischial spine and ganglion cyst at the entrance of Alcock's canal...
August 2016: Annals of Rehabilitation Medicine
Wenqiang Yang, Zhuangli Guo, Yanbing Yu, Jun Xu, Li Zhang
Surgery had been shown to be effective for superimposed peripheral nerve entrapment syndrome in patients with diabetic peripheral neuropathy (DPN), with pain relief and sensation restored. Few studies, however, have reported the quality-of-life outcomes of surgery for the treatment of painful DPN (PDPN). The objective of the present study was to evaluate the effects of microsurgical decompression of multiple entrapped peripheral nerves on pain and health-related quality of life in patients with refractory PDPN of the lower limbs...
September 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Amber M Shane, Christopher L Reeves, Ryan Vazales, Zachary Farley
Soft tissue impingement (STI) syndrome is one of 3 causes of a larger all-encompassing joint impingement pathologic condition, which also includes bone and neuropathic entrapment. Altered joint biomechanics and friction of joint tissues combine to cause chronic pain and often functional instability. Although the most common form of STI to the ankle is anterolateral in location, posterior and anteromedial impingement is also discussed in this article. Furthermore, a discussion of biomechanical deficiencies and how they may effect location and cause of STI of the ankle is explored along with pathophysiology, clinical and diagnostic evaluation, current treatments, and long-term outcomes...
October 2016: Clinics in Podiatric Medicine and Surgery
Zhao-Wen Zong, Quan-Wei Bao, Hua-Yu Liu, Yue Shen, Yu-Feng Zhao, Xiang Hua, Qing-Shan Guo, Lian-Yang Zhang, Hui Chen
PURPOSE: To enhance the awareness of rare complications of pelvic fracture and describe the correct diagnosis and effective treatment. METHODS: A total of 188 cases of pelvic fractures were retrospectively reviewed, and four patients who suffered from four types of rare pelvic fracture complications were described, namely ureteral obstruction caused by retroperitoneal hematoma-induced abdominal compartment syndrome (ACS), bowel entrapment, external iliac artery injury, and open scrotal sac injury...
August 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Agata Arazińska, Michał Polguj, Andrzej Wojciechowski, Łukasz Trębiński, Ludomir Stefańczyk
PURPOSE: Median arcuate ligament syndrome (MALS) is a pathologic entity that can affect the celiac axis. Due to the extensive collateral network of mesenteric circulation, stenosis of one mesenteric artery does not lead to significant symptoms. The purpose of this study was to describe multidetector computed tomography (MDCT) angiography findings of celiac artery entrapment by the median arcuate ligament and determine those patients with high risks of ischemic complications. MATERIALS AND METHODS: From January 2012 to March 2016, 103 patients with celiac artery (CA) compression by median arcuate ligament were detected...
August 25, 2016: Clinical Anatomy
Andrew D Franklin, G Bennett Cierny, Twila R Luckett
Meralgia paresthetica is a chronic pain syndrome that is extremely rare in the pediatric population. It is manifested by hypesthesia or pain in the distribution of the lateral femoral cutaneous nerve (LFCN) and is typically caused by entrapment as the nerve passes deep to the inguinal ligament. This sensory mononeuropathy is rare in children and diagnosis is typically delayed, often leading to prolonged functional impairment and unnecessary medical testing. A 9-year-old girl presented to the pain clinic with a 6-week history of right anterolateral thigh pain first noticed after a nontraumatic cheerleading practice...
September 2016: Journal of Clinical Anesthesia
Tomas Herma, Vaclav Baca, Danylo Yershov, David Kachlik
We have found an interesting coincidental variation of the superficial branch of the radial nerve and the brachioradialis muscle in a male cadaver. The superficial branch of the radial nerve was duplicated with one branch taking an aberrant course between two bellies of the brachioradialis muscle. The variant brachioradialis muscle featured two muscle bellies, a superficial one and a deep one, with one common origin and one common insertional tendon. The accessory nerve branch was impinged by two blood vessels and pierced through muscle bundles connecting two bellies of the brachioradialis muscle...
August 23, 2016: Surgical and Radiologic Anatomy: SRA
Jeremy R Glissen Brown, Gregory R Bernstein, Frank K Friedenberg, Adam C Ehrlich
Chronic abdominal wall pain (CAWP) refers to a condition wherein pain originates from the abdominal wall itself rather than the underlying viscera. According to various estimates, 10% to 30% of patients with chronic abdominal pain are eventually diagnosed with CAWP, usually after expensive testing has failed to uncover another etiology. The most common cause of CAWP is anterior cutaneous nerve entrapment syndrome. The diagnosis of CAWP is made using an oft-forgotten physical examination finding known as Carnett's sign, where focal abdominal tenderness is either the same or worsened during contraction of the abdominal musculature...
November 2016: Journal of Clinical Gastroenterology
Robert R Hagan, Michael A Fallucco, Jeffrey E Janis
BACKGROUND: Supraorbital rim syndrome (SORS) is a novel term attributed to a composite of anatomically defined peripheral nerve entrapment sites of the supraorbital rim region. The SORS term establishes a more consistent nomenclature to describe the constellation of frontal peripheral nerve entrapment sites causing frontal headache pain. In this article, we describe the anatomical features of SORS and evidence to support its successful treatment using the transpalpebral approach that allows direct vision of these sites and the intraconal space...
July 2016: Plastic and Reconstructive Surgery. Global Open
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