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Entrapment Neuropathy

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https://www.readbyqxmd.com/read/28075090/carpal-tunnel-syndrome-diagnosis-and-management
#1
Jennifer Wipperman, Kyle Goerl
Carpal tunnel syndrome, the most common entrapment neuropathy of the upper extremity, is caused by compression of the median nerve as it travels through the carpal tunnel. Classically, patients with the condition experience pain and paresthesias in the distribution of the median nerve, which includes the palmar aspect of the thumb, index and middle fingers, and radial half of the ring finger. Additional clues include positive physical examination findings, such as the flick sign, Phalen maneuver, and median nerve compression test...
December 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/28050946/diagnosing-carpal-tunnel-syndrome-with-doppler-ultrasonography-a-comparison-of-ultrasonographic-measurements-and-electrophysiological-severity
#2
Nihal Kutlar, Ayse Oytun Bayrak, İlkay Koray Bayrak, Sevgi Canbaz, Hande Türker
INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Diagnosis is based on clinical history, physical examination, and electrophysiological studies. Imaging techniques are performed for difficult-to-diagnose cases because they provide information about the morphology of the median nerve. More recently, it has been shown that Doppler ultrasonography can detect increased intraneural blood flow in CTS. The aim of our study is to evaluate the relationship between the severity of CTS, hypervascularization, and cross-sectional area (CSA) to determine the diagnostic value of Doppler ultrasonography...
February 2017: Neurological Research
https://www.readbyqxmd.com/read/28050354/a-case-report-on-unilateral-accessory-humeral-head-of-pronator-teres
#3
Suman Verma, Sulochana Sakthivel
The presence of an accessory muscle in the forearm is likely to compress on the neurovascular structures and has clinical implications. We encountered an accessory humeral head of pronator teres during routine dissection of left upper limb in a male cadaver. The accessory head had fleshy origin from medial supracondylar line, medial intermuscular septum and brachialis fascia. It coursed downwards in the cubital region covering brachial artery and median nerve. Further, it narrowed becoming mostly tendinous and joined with the humeral head of pronator teres...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28038479/acute-improvement-in-intraoperative-emg-following-common-fibular-nerve-decompression-in-patients-with-symptomatic-diabetic-sensorimotor-peripheral-neuropathy-1-emg-results
#4
James C Anderson, D Scott Nickerson, Brian L Tracy, Roger J Paxton, Dwayne S Yamasaki
Background and Study Aims Electromyographic (EMG) recordings of the fibularis longus (FL) and tibialis anterior (TA) muscles were performed intraoperatively during common fibular nerve (CFN) nerve decompression (ND) in patients with symptomatic diabetic sensorimotor peripheral neuropathy (DSPN) and clinical nerve compression. Materials and Methods Forty-six legs in 40 patients underwent surgical ND by external neurolysis; FL and TA muscles were monitored intraoperatively. Evoked EMGs were recorded just prior to and within 1 minute after ND...
December 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28000493/accessory-coracobrachialis-muscle-with-two-bellies-and-abnormal-insertion-case-report
#5
George Paraskevas, Konstantinos Koutsouflianiotis, Kalliopi Iliou, Theodosis Bitsis, Panagiotis Kitsoulis
OBJECTIVE: In the current study a brief review is presented of the coracobrachialis muscle's morphological variability, action, embryological development and clinical significance. CASE REPORT: We report a case of a left-sided coracobrachialis muscle consisting of two bellies. The deep belly inserts into the usual site in the middle area of the anteromedial aspect of the left humerus, whereas the superficial belly inserts through a muscular slip into the brachial fascia and the medial intermuscular septum, forming a musculo-aponeurotic tunnel in the middle region of the left arm, for the passage of the median nerve, brachial artery and veins, medial antebrachial cutaneous nerve and ulnar nerve...
November 2016: Acta Medica Academica
https://www.readbyqxmd.com/read/27989968/superior-cluneal-nerve-entrapment-neuropathy-and-gluteus-medius-muscle-pain-their-effect-on-very-old-patients-with-low-back-pain
#6
Rinko Kokubo, Kyongsong Kim, Toyohiko Isu, Daijiro Morimoto, Naotaka Iwamoto, Shiro Kobayashi, Akio Morita
OBJECTIVE: In the very elderly, their general condition and poor compliance with drug regimens can render the treatment of low back pain (LBP) difficult. We report the effectiveness of a less invasive treatment for intractable LBP from superior cluneal nerve entrapment neuropathy (SCN-EN) and gluteus medius muscle (GMeM) pain. PATIENTS AND METHODS: Between April 2013 and March 2015, we treated 17 consecutive elders with LBP and buttock- and leg pain (BuP, LP). They were 4 men and 13 women ranging in age from 85 to 91 years (mean 86...
October 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27987052/thoracic-outlet-syndrome-wide-literature-for-few-cases-status-of-the-art
#7
REVIEW
Pietro Emiliano Doneddu, Daniele Coraci, Paola De Franco, Ilaria Paolasso, Pietro Caliandro, Luca Padua
Despite its low prevalence and incidence, considerable debate exists in the literature on thoracic outlet syndrome (TOS). From literature analysis on nerve entrapments, we realized that TOS is the second most commonly published entrapment syndrome in the literature (after carpal tunnel syndrome) and that it is even more reported than ulnar neuropathy at elbow, which, instead, is very frequent. Despite the large amount of articles, there is still controversy regarding its classification, clinical picture, diagnostic objective findings, diagnostic modalities, therapeutical strategies and outcomes...
December 16, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27915068/effects-of-pulsed-ultrasound-therapy-on-sensory-nerve-conduction-parameters-and-the-pain-threshold-perceptions-in-humans
#8
Othmar Schuhfried, Damir Vukanovic, Christian Kollmann, Karin Pieber, Tatjana Paternostro-Sluga
BACKGROUND: Therapeutic ultrasound is an often-used clinical modality in the nonsurgical treatment of entrapment neuropathies. To date, the possible mechanism of action of pulsed ultrasound therapy on the peripheral nerve in the treatment of entrapment neuropathies is unclear. OBJECTIVE: To examine the effects of pulsed ultrasound therapy on peripheral nerve conduction parameters. DESIGN: A prospective, randomized, single blind, crossover study...
November 30, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27906945/ganglion-cyst-at-the-proximal-tibiofibular-joint-in-a-patient-with-painless-foot-drop
#9
Abdulmuhsen Alsahhaf, Waleed Renno
Entrapment neuropathies of the fibular nerve and its branches are often underdiagnosed due to the lack of reliable diagnosis using clinical examination and electrophysiologic evaluation. Most fibular nerve compressions may be classified into 2 broad categories: (a) mechanical causes, which occur at fibrous or fibro-osseous tunnels, and (b) dynamic causes related to nerve injury during specific limb positioning. Foot drop resulting from weakness of the dorsiflexor muscles of the foot is a relatively uncommon presentation and closely related to L5 neuropathy caused by a disc herniation...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27902538/ulnar-tunnel-syndrome-radial-tunnel-syndrome-anterior-interosseous-nerve-syndrome-and-pronator-syndrome
#10
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27900300/treatment-of-proximal-hamstring-tendinopathy-related-sciatic-nerve-entrapment-presentation-of-an-ultrasound-guided-intratissue-percutaneous-electrolysis-application
#11
Gabriele Mattiussi, Carlos Moreno
BACKGROUND: Proximal Hamstring Tendinopathy-related Sciatic Nerve Entrapment (PHTrSNE) is a neuropathy caused by fibrosis interposed between the semimembranosus tendon and the sciatic nerve, at the level of the ischial tuberosity. METHODS: Ultrasound-guided Intratissue Percutaneous Electrolysis (US-guided EPI) involves galvanic current transfer within the treatment target tissue (fibrosis) via a needle 0.30 to 0.33 mm in diameter. The galvanic current in a saline solution instantly develops the chemical process of electrolysis, which in turn induces electrochemical ablation of fibrosis...
April 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/27875620/a-reliable-technique-for-us-guided-perineural-injection-in-ulnar-neuropathy-at-the-elbow
#12
Ulrike M Hamscha, Ines Tinhofer, Stefan Heber, Wolfgang Grisold, Wolfgang J Weninger, Stefan Meng
INTRODUCTION: Ulnar neuropathy at the elbow (UNE) is a common peripheral compression neuropathy and in most cases occurs at 2 sites, the retroepicondylar groove or the cubital tunnel. With regard to a potential therapeutic approach with perineural corticosteroid injection the aim of this study was to evaluate the distribution of injection fluid applied at a standard site. METHODS: We performed ultrasound-guided (US-guided) perineural injections to the ulnar nerve halfway between the olecranon and the medial epicondyle in 21 upper limbs from 11 non-embalmed cadavers...
November 22, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27867513/ultrasound-guided-alcohol-neurolysis-of-lateral-femoral-cutaneous-nerve-for-intractable-meralgia-paresthetica-a-case-series
#13
Arif Ahmed, Divesh Arora, Amit Kumar Kochhar
Meralgia paresthetica is a rare sensory entrapment neuropathy which leads to burning, tingling and numbness in the antero-lateral aspect of thigh. Mostly it runs a benign course, and responds to conservative measures. We present a case series of six patients with intractable meralgia paresthetica with severe pain over antero-lateral thigh along the distribution of lateral cutaneous nerve of thigh which was further confirmed by nerve conduction study. These patients did not respond to the oral anti-neuropathic medications...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27861415/decompressive-surgery-for-diabetic-neuropathy-waiting-for-incontrovertible-proof
#14
Martijn R Tannemaat, Mirjam Datema, J Gert van Dijk, Rajiv Midha, Martijn J A Malessy
: : Triple decompression surgery has been advocated as a treatment for diabetic peripheral neuropathy (DPN). A practice advisory published in 2006 by the American Academy of Neurology concluded that "this treatment alternative should be considered unproven." Since then, multiple cohort studies involving several thousands of patients and 1 nonblind, randomized, controlled trial have been published, suggesting that surgical treatment of DPN has become commonplace in many centers globally...
December 2016: Neurosurgery
https://www.readbyqxmd.com/read/27857636/posterior-lateral-and-anterior-hip-pain-due-to-musculoskeletal-origin-a-narrative-literature-review-of-history-physical-examination-and-diagnostic-imaging
#15
REVIEW
Patrick J Battaglia, Kevin D'Angelo, Norman W Kettner
OBJECTIVE: The purpose of this study was to present a narrative review of the literature of musculoskeletal causes of adult hip pain, with special attention to history, physical examination, and diagnostic imaging. METHODS: A narrative review of the English medical literature was performed by using the search terms "hip pain" AND "anterior," "lateral," and "posterior." Additionally, specific entities of hip pain or pain referral sources to the hip were searched for...
December 2016: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/27854094/cubital-tunnel-syndrome-caused-by-ulnar-nerve-schwannoma-in-a-patient-with-diabetic-sensorimotor-polyneuropathy
#16
Meng-Ta Liu, Jiunn-Tay Lee, Chih-Hsin Wang, Yu-Chieh Lin, Chung-Hsing Chou
PURPOSE: An uncommon ulnar nerve schwannoma should not be neglected in a diabetic patient with cubital tunnel syndrome, the second most common cause of entrapment neuropathy. CASE REPORT: A 61-year-old woman with a past history of type 2 diabetes mellitus complicated with sensorimotor polyneuropathy presented with progressive numbness and weakness of the left ring and little fingers for one year. A provisional diagnosis of cubital tunnel syndrome was made according to physical examination and electrophysiological studies...
June 15, 2016: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/27845501/treatment-for-ulnar-neuropathy-at-the-elbow
#17
REVIEW
Pietro Caliandro, Giuseppe La Torre, Roberto Padua, Fabio Giannini, Luca Padua
BACKGROUND: Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy after carpal tunnel syndrome. Treatment may be conservative or surgical, but optimal management remains controversial. This is an update of a review first published in 2010 and previously updated in 2012. OBJECTIVES: To determine the effectiveness and safety of conservative and surgical treatment in ulnar neuropathy at the elbow (UNE). We intended to test whether:- surgical treatment is effective in reducing symptoms and signs and in increasing nerve function;- conservative treatment is effective in reducing symptoms and signs and in increasing nerve function;- it is possible to identify the best treatment on the basis of clinical, neurophysiological, or nerve imaging assessment...
15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27843079/morphology-and-morphometry-of-the-ulnar-head-of-the-pronator-teres-muscle-in-relation-to-median-nerve-compression-at-the-proximal-forearm
#18
I A Gurses, L Altinel, O Gayretli, T Akgul, I Uzun, F Dikici
INTRODUCTION: The pronator syndrome is a rare compression neuropathy of the median nerve. Ulnar head of the pronator teres muscle may cause compression at proximal forearm. HYPOTHESIS: Detailed morphologic and morphometric studies on the anatomy of the ulnar head of pronator teres is scarce. MATERIAL AND METHODS: We dissected 112 forearms of fresh cadavers. We evaluated the morphology and morphometry of the ulnar head of pronator teres muscle...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27830881/transtendinous-course-of-the-infrapatellar-branch-of-saphenous-nerve-a-contribution-to-the-aetiology-of-entrapment-neuropathy-and-modification-of-the-existing-classification
#19
K Natsis, G Konstantinidis, G Geropoulos, T Totlis, N Lazaridis, T Tegos
BACKGROUND: The course of the infrapatellar branch of saphenous nerve (IPBSN) in relation to the Sartorius muscle has been classified into presartorial, transsartorial and retrosartorial types. Mechanical compression of the IPBSN within the Sartorius tendon has been surgically recognised as a cause of entrapment neuropathy. Purpose of the present study was to differentiate the IPBSNs penetrating the Sartorius tendon from those penetrating the Sartorius muscle, from an anatomical and clinical point of views and thus modifying the existing classification...
2016: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/27815973/validation-of-preoperative-nerve-conduction-studies-by-intraoperative-studies-in-patients-with-ulnar-neuropathy-at-the-elbow
#20
Gregor Omejec, Krešimir Božikov, Simon Podnar
OBJECTIVE: To validate the findings of preoperative motor short-segment nerve conduction studies (SSNCSs) by intraoperative SSNCSs in patients with cubital tunnel syndrome. METHODS: We prospectively recruited patients with ulnar neuropathy at the elbow (UNE) localized distal to the medial epicondyle (ME). Preoperatively, motor SSNCSs and ultrasonography (US) were performed. Immediately after surgical dissection of the humeroulnar aponeurotic arcade (HUA), intraoperative near-nerve motor SSNCSs were performed, and compared to preoperative findings...
December 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
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