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Entrapment Neuropathy

Brigitte Tampin, Jan Vollert, Annina B Schmid
OBJECTIVE: Distal and proximal entrapment neuropathies such as carpal tunnel syndrome (CTS) and cervical radiculopathy (CR) share similar etiologies. Experimental models suggest that despite comparable etiology, pathomechanisms associated with injuries of the peripheral and central axon branches are distinct. This study therefore compared self-reported and elicited sensory profiles in patients with distal and proximal entrapment neuropathies. METHODS: Patients with electrodiagnostically confirmed CTS (n = 103) and patients with CR (n = 23) were included in this study...
March 10, 2018: Current Medical Research and Opinion
Erek W Latzka, P Troy Henning, Adam M Pourcho
Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy, resulting in 500,000 carpal tunnel release (CTR) surgeries and a total cost of over 2 billion dollars annually in the United States.1,2 Although initially performed via a large (3-5 cm), palmar incision, CTR techniques have continually evolved to reduce recovery times and post-operative pain, and improve cosmesis and clinical outcomes.2,3 More recently, multiple authors have reported excellent results following ultrasound-guided carpal tunnel release (USCTR) using a variety techniques, and one prospective randomized trial reported faster recovery following USCTR compared to traditional mini-open CTR...
March 5, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
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
A Vidoni, M Shrivastava, Rajesh Botchu
Carpal tunnel syndrome (CTS) represents the most common entrapment neuropathy of the upper extremity. Intermittent CTS has been reported in the surgical literature and usually, related to masses associated to flexor tendons. We describe a patient with an intrasynovial lipoma involving the deep flexor of the middle finger causing intermittent CTS and snapping on flexion-extension.
February 10, 2018: Journal of Ultrasound
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
Annina B Schmid, Louise Hailey, Brigitte Tampin
Entrapment neuropathies are the most prevalent type of peripheral neuropathy and often a challenge to diagnose and treat. To a large extent, our current knowledge is based on empirical concepts and early (often biomechanical) studies. This Viewpoint will challenge some of the current beliefs with recent advances in both basic and clinical neurosciences. J Orthop Sports Phys Ther 2018;48(2):58-62. doi:10.2519/jospt.2018.0603.
February 2018: Journal of Orthopaedic and Sports Physical Therapy
Michinori Nariai, Kyongsong Kim, Masaaki Kawauchi, Akihiro Ishii, Misa Kido, Toyohiko Isu, Rinko Kokubo, Daijiro Morimoto, Naotaka Iwamoto, Akio Morita
BACKGROUND: Tarsal tunnel syndrome(TTS)is an entrapment neuropathy of the posterior tibial nerve within the tarsal tunnel below the medial malleolus. An accurate diagnosis is difficult, and TTS is usually diagnosed from clinical symptoms due to the lack of accurate diagnostic tools. We aimed to standardize the diagnosis of TTS using MRI, and report the MRI conditions for clear visualization of the tarsal tunnel. METHODS: We investigated which sequences and MRI conditions would be appropriate for the imaging of the tarsal tunnel in a healthy volunteer...
January 2018: No Shinkei Geka. Neurological Surgery
John Souter, Kevin Swong, Matthew McCoyd, Neelam Balasubramanian, Magan Nielsen, Vikram C Prabhu
BACKGROUND: Common peroneal nerve (CPN) compressive neuropathy is the most common lower extremity entrapment neuropathy. MATERIALS & METHODS: A retrospective review of a prospectively maintained single-institution database of all cases of CPN palsy that underwent decompression and neuroplasty over a five-year period was performed. RESULTS: Thirty patients underwent a neuroplasty of the CPN over a five year period (2010-2015) at our institution...
January 17, 2018: World Neurosurgery
Özgür Bilgin Topçuoğlu, Özlem Oruç, Sema Saraç, Gülgün Çetintaş Afşar, Kayıhan Uluç
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. It is usually associated with the compression of the median nerve in the median groove. Because the main symptoms of CTS pain and numbness worsen at night, sleep disorders in CTS patients and the impact of preferred sleeping position on CTS development have been formerly studied. However, to the best of our knowledge, this is the first study assessing the frequency of CTS in obstructive sleep apnea (OSA) patients...
December 2017: Noro Psikiyatri Arsivi
Panagiotis Zis, Marios Hadjivassiliou, Ptolemaios Georgios Sarrigiannis, Alexander St John Edward Barker, Dasappaiah Ganesh Rao
Background and Aim: Pure sensory neuropathies involving the dorsal root ganglia are commonly referred to as sensory ganglionopathies (SG). Causes of SG can be inherited (as seen in Friedreich's ataxia) or acquired (e.g. immune-mediated or paraneoplastic). Diagnostic criteria for confirming SG have been published and consist of a combination of clinical and neurophysiological parameters. The aim of our study was to develop a neurophysiological method for rapid screening for diagnosis of SG...
December 2017: Brain and Behavior
Russell A Payne, Kimberly Harbaugh, Charles S Specht, Elias Rizk
Meralgia paresthetica is a neuropathic pain disorder resulting from an entrapment neuropathy of the lateral femoral cutaneous nerve. This condition results in pain, paresthesias and numbness over the anterolateral aspect of the thigh. We present a case of meralgia paresthetica and discuss both the clinical and histopathological findings as they relate to one another. We report a case of meralgia paresthetica refractory to conservative treatment who underwent neurectomy with successful treatment of symptoms...
October 20, 2017: Curēus
Shinkyoung Kim, Hyeungjune Kim, Dong In Jo, Sang-Jun Na, Yoon-Sik Jo
INTRODUCTION: Although ganglion cysts are common soft tissue tumors, nerve compression syndrome caused by a ganglion cyst in the lower extremities is very rare. Herein, we report a 57-year-old man who presented with hypoesthesia in the sole of his right foot for 6 months. We believe that reporting this rare case will help clinicians update their knowledge on possible causes of the plantar neuropathy, and avoid diagnostic delay. PRESENTATION OF CASE: The patient had pain and numbness in the inner right sole, as well as a tingling and dull sensation...
December 12, 2017: International Journal of Surgery Case Reports
Matthew Howard, Lukas Sahhar, Frank Andrews, Ralph Bergman, Douglas Gin
Notalgia paresthetica (NP) is an underdiagnosed condition that presents with unilateral pruritus medial to the scapula on the midback with or without an associated hyperpigmented or hypopigmented macule. There is a paucity of recent reviews on this chronic cutaneous neuropathy in peer-reviewed journals. Current theories propose the condition is likely multifactorial, including spinal entrapment and muscular compressive neuropathy. An extensive literature review was performed by searching the MEDLINE database to review all published works on notalgia paresthetica...
December 15, 2017: International Journal of Dermatology
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
Kyomin Choi, So Hyun Ahn, Seol-Hee Baek, Jun-Soon Kim, Seok-Jin Choi, Je-Young Shin, Sung-Min Kim, Yoon-Ho Hong, Jung-Joon Sung
Spinobulbar muscular atrophy (SBMA) is an X-linked recessive disease, presenting motor weakness and wasting of facial, bulbar and limb muscles. Hereditary neuropathy with liability to pressure palsy (HNPP) is autosomal dominant disorder characterized by recurrent neuropathies at common entrapment sites. We report a case of co-existence of SBMA and atypical HNPP with genetic confirmation of CAG expansion in the androgen receptor (AR) gene and deletion of the peripheral myelin protein 22 (PMP22) gene. A 62-year-old man presented with progressive muscle weakness, fasciculations in upper and lower limbs and dysesthesia predominantly in the distal regions...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Kazutoshi Kubo, Yu-Shiuan Cheng, Boran Zhou, Kai-Nan An, Steven L Moran, Peter C Amadio, Xiaoming Zhang, Chunfeng Zhao
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy occurring in upper limbs. The etiology, however, has not been fully understood yet. Median nerve could be compressed by either increase of carpal tunnel pressure (CTP) or direct impingement when it is forced toward to carpal ligament especially in wrist flexion leading to CTS development. Thus, the increase of carpal tunnel pressure is considered an important role in CTS development. It has been identified that forces applied to the palm would affect the CTP...
November 4, 2017: Journal of Biomechanics
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
Kyongsong Kim, Jun Shimizu, Toyohiko Isu, Kiyoharu Inoue, Yasuhiro Chiba, Naotaka Iwamoto, Daijiro Morimoto, Masanori Isobe, Akio Morita
INTRODUCTION: We studied the clinical and nerve pathologic features in 6 patients whose low back pain (LBP) was relieved by superior cluneal nerve (SCN) neurectomy to determine whether nerve compression was the mechanism underlying this type of LBP. METHODS: All 6 patients (7 nerves) underwent SCN neurectomy for intractable LBP. Their clinical outcomes and the pathologic features of 7 nerves were reviewed. RESULTS: All patients reported LBP relief immediately after SCN neurectomy...
November 3, 2017: Muscle & Nerve
Ankita Aggarwal, Manisha Jana, Vijay Kumar, Deep Narayan Srivastava, Kanwaljeet Garg
Intraosseous entrapment of the median nerve is an uncommon complication of elbow dislocation and fractures. The condition is seen to occur in adolescent age group with a remote history of trauma. We report two rare cases of type 2 intraosseous median nerve entrapment. Though the diagnosis of median neuropathy is made with clinical tests and neurophysiological studies, however exact site of entrapment and presurgical mapping of nerve is done accurately with MR neurography. Imaging thus plays a pivotal role in management of this condition...
October 28, 2017: World Journal of Radiology
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