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Entrapment Neuropathy

Adeniyi A Borire, Ria Arnold, Bruce A Pussell, Natalie C Kwai, Leo H Visser, Luca Padua, Neil G Simon, Matthew C Kiernan, Arun V Krishnan
OBJECTIVE: We explored the nerve ultrasound (US) characteristics of 15 patients with end-stage kidney disease (ESKD) and correlated these findings with clinical severity and electrophysiological parameters of neuropathy. METHODS: 15 ESKD patients on thrice-weekly high-flux haemodialysis and 15 healthy controls were enrolled. Sonographic and electrophysiologic studies were conducted before and after a single session of haemodialysis. Serial measurements of median nerve cross-sectional area (CSA) and hypoechoic fraction (HF) were performed at the same non-entrapment site in the mid-forearm...
October 1, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Hideki Urano, Katsuyuki Iwatsuki, Michiro Yamamoto, Tetsuro Ohnisi, Shigeru Kurimoto, Nobuyuki Endo, Hitoshi Hirata
We developed a novel hydrogel derived from sodium carboxymethylcellulose (CMC) in which phosphatidylethanolamine (PE) was introduced into the carboxyl groups of CMC to prevent perineural adhesions. This hydrogel has previously shown excellent anti-adhesive effects even after aggressive internal neurolysis in a rat model. Here, we confirmed the effects of the hydrogel on morphological and physiological recovery after nerve decompression. We prepared a rat model of chronic sciatic nerve compression using silicone tubing...
2016: PloS One
Georgios Tsivgoulis, Andrei V Alexandrov
PURPOSE OF REVIEW: Low cost, avoidance of irradiation, and high temporal resolution are inherent advantages of ultrasound imaging that translate into multiple clinical uses in many domains of neurology. This article presents clinical uses of ultrasound examination in cerebrovascular, neurodegenerative, and peripheral nervous system diseases. RECENT FINDINGS: Modern treatment and prevention of ischemic stroke rely on prompt diagnosis. Ultrasonography has found a place as a noninvasive screening test and bedside technique that provides estimates of the degree of stenosis as well as hemodynamic and structural information about intracranial and extracranial vessels in real time...
October 2016: Continuum: Lifelong Learning in Neurology
Burcu Örmeci, Egemen Avcı, Çigdem Kaspar, Özlem Eranıl Terim, Tibet Erdoğru, A Emre Öge
OBJECTIVES: To examine the diagnostic value of pudendal somatosensory evoked potentials (SEP) in pudendal nerve entrapment neuropaty (PNE) by stimulating the two sides separately after provocation by a standard sitting position. Routine pudendal SEPs performed in the supine position with bilateral simultaneous stimulation may fail to show the abnormality because the complaints of PNE appear or worsen in the sitting position. METHODS: Forty-nine patients with PNE and 16 controls were included...
October 7, 2016: Urology
Morimoto Daijiro, Isu Toyohiko, Kim Kyongsong, Chiba Yasuhiro, Iwamoto Naotaka, Isobe Masanori, Morita Akio
STUDY DESIGN: Prospective observational cohort study. OBJECTIVE: The objective of this study was to present the long-term surgical outcomes of operative treatment for superior cluneal nerve (SCN) entrapment neuropathy (SCNEN) and to analyze the causes of poor results and further treatment required. SUMMARY OF BACKGROUND DATA: There are few reports of the outcomes of surgical treatment for SCNEN, and most studies describe results for operations conducted under general anesthesia with short follow-up periods...
September 23, 2016: Spine
Vibhor Wadhwa, Aws S Hamid, Yogesh Kumar, Kelly M Scott, Avneesh Chhabra
Pudendal neuralgia is being increasingly recognized as a cause of chronic pelvic pain, which may be related to nerve injury or entrapment. Due to its complex anatomy and branching patterns, the pudendal nerve abnormalities are challenging to illustrate. High resolution 3 T magnetic resonance neurography is a promising technique for the evaluation of peripheral neuropathies. In this article, the authors discuss the normal pudendal nerve anatomy and its variations, technical considerations of pudendal nerve imaging, and highlight the normal and abnormal appearances of the pudendal nerve and its branches with illustrative case examples...
September 23, 2016: Acta Radiologica
Eugenia Rota, Nicola Morelli
Neuropathy is a common complication of diabetes mellitus (DM) with a wide clinical spectrum that encompasses generalized to focal and multifocal forms. Entrapment neuropathies (EN), which are focal forms, are so frequent at any stage of the diabetic disease, that they may be considered a neurophysiological hallmark of peripheral nerve involvement in DM. Indeed, EN may be the earliest neurophysiological abnormalities in DM, particularly in the upper limbs, even in the absence of a generalized polyneuropathy, or it may be superimposed on a generalized diabetic neuropathy...
September 15, 2016: World Journal of Diabetes
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
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
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
Takao Murohashi, Mitsunori Yoshimoto, Tsuneo Takebayashi, Shuichi Hashimoto, Shouto Yamada, Hiroyuki Takashima, Toshihiko Yamashita
PURPOSE: The measurement of distal motor latency (DML) is an established method for diagnosing entrapment peripheral neuropathy. DML can also serve as an index for disease severity and prognosis. We considered that measuring DML could be useful in estimating the severity of spinal root impairment and predicting prognosis in patients with lumbar spinal stenosis (LSS). The purpose of this study was to investigate the efficacy of intraoperative direct electrical stimulation of the spinal root and the measurement of DML in LSS...
September 9, 2016: European Spine Journal
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
Ekin Şavk
Neurologic itch is defined as pruritus resulting from any dysfunction of the nervous system. Itch arising due to a neuroanatomic pathology is seen to be neuropathic. Causes of neuropathic itch range from localized entrapment of a peripheral nerve to generalized degeneration of small nerve fibers. Antipruritic medications commonly used for other types of itch such as antihistamines and corticosteroids lack efficacy in neuropathic itch. Currently there are no therapeutic options that offer relief in all types of neuropathic pruritus, and treatment strategies vary according to etiology...
2016: Current Problems in Dermatology
Juan M Duarte, Héctor M D'Onofrio, Juan Ignacio Rolón, Alicia C Bertotti
Carpal tunnel síndrome (CTS) is an entrapment neuropathy of the median nerve at the wrist, that leads to pain, paresthesia and painful dysesthesia. The electrophysiological diagnosis is based upon nerve conduction studies which evaluate thick nerve fibers. Our hypothesis is that there is an additional dysfunction of small fibers in CTS, which correlates with the degree of severity of the neuropathy. A retrospective study of 69 hands that belonged to 47 patients of both sexes (mean age 53.8, years, range 22-87) was performed, and, as a control group, 21 hands which corresponded to the asymptomatic side of those patients were evaluated...
2016: Medicina
Souichi Ohta, Ryosuke Ikeguchi, Takashi Noguchi, Yukitoshi Kaizawa, Hiroki Oda, Shuichi Matsuda
Surgical treatment for recurrent, common peroneal neuropathy has not been reported. Herein, we describe a successfully treated case using the proximally based sural fasciocutaneous flap after reneurolysis of the adhesive common peroneal nerve. A 33-year-old man received a neurolysis operation for entrapment neuropathy of the common peroneal nerve 2 years before first admission in our clinic. Although motor nerve conduction studies showed a marked improvement after the primary operation, the patient always required the use of a crutch because of severe pain radiating to the lower leg during standing or walking...
July 2016: Plastic and Reconstructive Surgery. Global Open
Duygu Geler Külcü, Canan Bursali, İlknur Aktaş, Selin Bozkurt Alp, Feyza Ünlü Özkan, Pınar Akpinar
BACKGROUND/AIM: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Conservative treatment choices are not always satisfactory. The aim of this study was to investigate the effect of kinesiotaping (KT) on pain level, grip strength, and functional status compared with that of placebo KT and orthotic device (OD) in patients with CTS. MATERIALS AND METHODS: In this randomized, placebo-controlled study, participants were allocated into one of three groups: an experimental KT group (Group 1), a placebo KT group (Group 2), and an OD group (Group 3)...
2016: Turkish Journal of Medical Sciences
Kai F Loewenbrück, Markus Dittrich, Josef Böhm, Jürgen Klingelhöfer, Petra Baum, Jochen Schäfer, Rainer Koch, Alexander Storch
The objective of this study is to compare the diagnostic accuracy of nerve ultrasound (US) and nerve conduction studies (NCS) for acquired non-entrapment peripheral neuropathies (PNP) and hereditary motor and sensory neuropathies (HMSN) in a routine clinical setting. The methods are based on a single-center, prospective, examiner-blinded cross-sectional study on three subject groups of healthy controls, PNP (both enrolled by a consecutive recruitment strategy), and HMSN patients (convenience sample). A clinical reference standard based on the neuropathy impairment (NIS) and neuropathy symptoms scores (NSS) was used for PNP as the external validation criterion...
November 2016: Journal of Neurology
Marcus R Bair, Michael T Gross, Jennifer R Cooke, Carla H Hill
Study Design Resident's case problem. Background Entrapment neuropathies represent a diagnostic challenge and require a comprehensive understanding of the nerve's path and the anatomical structures that may cause compression of the nerve. This resident's case problem details the evaluation and differential diagnosis process for median nerve entrapment resulting from forceful and repetitive pronation/supination motions. Diagnosis Median nerve compression syndromes include pronator syndrome, anterior interosseous nerve syndrome, and carpal tunnel syndrome...
September 2016: Journal of Orthopaedic and Sports Physical Therapy
Ozge Gulsum Illeez, Feyza Unlu Ozkan, Ozan Ozkaya, Ilknur Aktas, Korhan Ozkan
Carpal tunnel syndrome (CTS), the most common entrapment neuropathy in adulthood, is rare in childhood. The symptoms may differ to those in adults, or may be misinterpreted owing to children's difficulties in expressing themselves. Cases of idiopathic, bilateral CTS under the age of 5 are rare. A 4-year-old girl presented with pain in both hands and difficulty opening them in the morning. Bilateral severe CTS was determined at electroneuromyography (ENMG). Bilateral wrist splints were advised for both hands...
July 31, 2016: Journal of Tropical Pediatrics
Larissa T Baselgia, David L Bennett, Robert M Silbiger, Annina B Schmid
OBJECTIVE: To examine differences in somatosensory phenotypes of patients with positive and negative neurodynamic tests and compare these with healthy participants. DESIGN: Case-control study. SETTING: University department. PARTICIPANTS: Patients with electrodiagnostically confirmed carpal tunnel syndrome (CTS) (n=53) and people without CTS (n=26) participated in this study (N=79). Patients with CTS were subgrouped according to the results of the upper limb neurodynamic tests biasing the median nerve into patients with positive or negative neurodynamic tests...
July 20, 2016: Archives of Physical Medicine and Rehabilitation
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