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Books on the topic 'Compressive neuropathy'
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1
Donaghy, Michael. Focal peripheral neuropathy. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569381.003.0487.
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Some causes of focal peripheral nerve damage are self-evident, such as involvement at sites of trauma, tissue necrosis, infiltration by tumour, or damage by radiotherapy. Focal compressive and entrapment neuropathies are particularly valuable to identify in civilian practice, since recovery may follow relief of the compression. Leprosy is a common global cause of focal neuropathy, which involves prominent loss of pain sensation with secondary acromutilation, and requires early antibiotic treatment. Mononeuritis multiplex due to vasculitis requires prompt diagnosis and immunosuppressive treatment to limit the severity and extent of peripheral nerve damage. Various other medical conditions, both inherited and acquired, can present with focal neuropathy rather than polyneuropathy, the most common of which are diabetes mellitus and hereditary liability to pressure palsies. A purely motor focal presentation should raise the question of multifocal motor neuropathy with conduction block, which usually responds well to high-dose intravenous immunoglobulin infusions.
2
Wilson, Thomas J., and Robert J. Spinner. Peroneal Neuropathy—Fibular Tunnel Syndrome. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0009.
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Common peroneal neuropathy is the most common compressive neuropathy of the lower extremity, often presenting with acute, progressive foot drop. The most common site of compression of the peroneal nerve is at the point that it courses around the neck of the fibula beneath the fascia of the peroneus longus. This chapter aims to help the surgeon evaluate for peroneal neuropathy using a combination of clinical history, physical examination, electrodiagnostics, and imaging. The chapter also discusses surgical and nonsurgical management of peroneal neuropathy, including a detailed discussion of the operative technique for decompression of the peroneal nerve at the fibular tunnel.
3
Katirji, Bashar. Case 8. Edited by Bashar Katirji. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190603434.003.0012.
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Peroneal (fibular) neuropathy is the most common entrapment/compressive mononeuropathy in the lower extremity, often presenting with foot drop and numbness. The majority of the lesions are across the fibular neck, but more proximal and distal lesions exist. This case presents the clinical and electrodiagnostic findings in peroneal neuropathy and discusses in detail the differential diagnoses of foot drop. It highlights the importance of distinguishing peroneal nerve lesions from L5 radiculopathy, lumbar plexopathy, and sciatic neuropathy. Causes of acute and subacute peroneal mononeuropathies are emphasized.
4
Shaibani, Aziz. Numbness. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190661304.003.0023.
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Sensory symptoms are the most common symptoms in neuromuscular clinics, yet it is hard to capture them via video unless they have a very specific pattern and they are associated with objective loss of sensation. Distal sensory loss is a common neuropathic finding. It follows gloves and stocks distribution. Sensory neuropathies may present with ataxia which results in falls, or severe pain. Neuropathic pain with normal ankle reflexes and sural responses suggest small fiber neuropathy. Multifocal sensory loss is usually vascular. It can also be infectious (leprosy). Migratory neuritis is a poorly understood condition. Intercostal pain and numbness is usually due to radiculopathy (diabetic, zoster, or compressive radiculopathy). Foots ulcers and unfelt mosquito bites are markers for sensory loss. Loss of corneal sensation may led to keratitis and blindness.
5
Maldonado, Andrés A., and Robert J. Spinner. Suprascapular Neuropathy. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0007.
Full textAbstract:
Suprascapular neuropathy results from a lesion affecting the suprascapular nerve and is typically due to compression or traction in association with other injuries. The differential diagnosis of suprascapular neuropathy includes rotator cuff pathology, cervical radiculopathy, and Parsonage-Turner syndrome. Suprascapular neuropathy leads to a spectrum of clinical symptoms, including pain and selected weakness in shoulder abduction and external rotation of the arm. Atrophy of the shoulder musculature affecting the spinati muscles (supraspinatus and infraspinatus) often becomes apparent after some months. Suprascapular neuropathy is a challenging diagnosis to make based on the history and physical examination alone, especially since shoulder pain is relatively common and multifactorial; in addition, suprascapular neuropathy can often coexist with other shoulder pathology. The indications for a surgical procedure are the failure of nonoperative management, with lack of clinical or electrical improvement in 6 to 9 months, and the presence of a space-occupying lesion causing compression of the suprascapular nerve. Direct nerve decompression by release of the suprascapular ligament is typically recommended in cases of symptomatic isolated suprascapular neuropathy.
6
Payne, Russell A., and Kimberly S. Harbaugh. Median Neuropathy—Pronator Teres Syndrome and Anterior Interosseous Neuropathy. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0003.
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Pronator teres syndrome results from median nerve compression or irritation at the elbow region. Patients typically note volar forearm pain and median sensory disturbance that includes the palm. Electrodiagnostic studies are helpful in excluding carpal tunnel syndrome and cervical radiculopathy, and findings may be normal in pronator syndrome. A lack of sensory findings and motor loss in flexion of the distal phalanx of the radial three digits suggests anterior interosseous nerve palsy, typically due to neuralgic amyotrophy. When conservative treatment fails, surgical release of all potential points of compression is successful in alleviating symptoms in the majority of patients with pronator syndrome.
7
Varma, Abhay K., and Ron Ron Cheng. Ulnar Neuropathy—Guyon’s Canal Syndrome. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0005.
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The chapter describes ulnar nerve compression at the wrist secondary to a mass lesion. The clinical picture can mimic pathology of the nerve roots or the brachial plexus or ulnar nerve entrapment at the elbow. Meticulous clinical examination and electrodiagnostic study help to differentiate ulnar nerve compression at the wrist from radiculopathy and to localize the site of compression. Imaging of the wrist is essential, as compression by an organic lesion is common. Conservative management is recommended when organic pathology has been ruled out and there is no motor involvement. Surgery is indicated when conservative treatment fails, there is motor weakness, or a mass lesion has been identified.
8
Lyons, Daniel A., and David L. Brown. Tibial Neuropathy—Tarsal Tunnel Syndrome. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0010.
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Tarsal tunnel syndrome (TTS) is caused by compression of the tibial nerve and its branches within the tarsal tunnel at the ankle. The diagnosis of TTS is often made clinically, but imaging and electrodiagnostic studies should be considered when the diagnosis cannot be ascertained from the clinical history and physical examination. Surgical decompression of the tarsal tunnels should be pursued only after conservative measures have failed or when a space-occupying lesion or point of tibial nerve compression has been identified. Surgical intervention requires complete release of the flexor retinaculum at the medial ankle, as well as release of the three distinct tunnels enveloping the medial and lateral plantar nerves and the calcaneal branch. Success rates for tibial nerve decompression vary widely in the literature, ranging from 44% to 96%.
9
Thaisetthawatkul, Pariwat, and Eric Logigian. Entrapment Neuropathy and Pregnancy. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0027.
Full textAbstract:
Entrapment neuropathy is caused by compression, angulation, or stretch of a peripheral nerve as it passes through a fibro-osseous canal such as the carpal or the cubital tunnel (in the case of the median or the ulnar nerves). In addition to true entrapment neuropathies, individual nerves can be injured at vulnerable anatomical locations such as the fibular head (in case of the fibular nerve). Pregnancy causes a variety of physiological changes related to reproductive hormone secretion that can affect peripheral nerve. These include weight gain, salt and water retention, edema and hyperglycemia.1 Two entrapment neuropathies that occur commonly in pregnancy are carpal tunnel syndrome and meralgia paresthetica.2 In addition to these true entrapment neuropathies, this chapter addresses other common focal mononeuropathies: femoral, obturator, and fibular neuropathies that may occur as a consequence of obstetrical procedures or of fetal or maternal positioning during delivery or in the postpartum period.
10
Cheng, Ron Ron, and Abhay K. Varma. Ulnar Neuropathy—Cubital Tunnel Syndrome. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0004.
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The chapter presents the typical scenario of ulnar nerve entrapment at the elbow. The clinical picture can mimic pathology of nerve roots, of the brachial plexus, or of the ulnar nerve at different sites. Electrodiagnostic study helps to differentiate ulnar nerve entrapment from radiculopathy and to localize the site of compression, while imaging (ultrasound and MR imaging) are useful adjuncts to clinical examination. Conservative management is recommended for intermittent symptoms and absence of motor involvement. Surgical procedures include in situ, open, or endoscopic decompression and nerve transposition. Subluxation of the nerve over the medial epicondyle and recurrent or persistent neuropathy after in situ decompression are indications for transposition.
11
Chiravuri, Srinivas. Lateral Femoral Cutaneous Neuropathy—Meralgia Paresthetica. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0014.
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Meralgia paresthetica is characterized by anterolateral thigh pain, paresthesia, or dysesthesia without motor weakness. This is due to idiopathic or iatrogenic injury to the lateral femoral cutaneous nerve (LFCN, dorsal rami of L2-L3). Risk factors include obesity, diabetes, and external compression near the inguinal ligament’s attachment to the anterior superior iliac spine. Diagnosis is based on clinical presentation and electrodiagnostic studies. Initial management includes behavioral modification, physical therapy, and pharmacotherapy. More invasive treatment modalities include LFCN infiltration, pulsed radiofrequency, direct nerve stimulation, and spinal cord stimulation. Ultrasound-guided neurectomy is also an effective way to localize the nerve structure and ensure complete nerve transection.
12
Murinova, Natalia, and Daniel Krashin. Susceptibility of Peripheral Nerves in Diabetes to Compression and Implications in Pain Treatment. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190626761.003.0006.
Full textAbstract:
Diabetes affects a large and growing percentage of the population in most countries of the world. Diabetes causes many different health problems, but among the most severe and disabling is peripheral neuropathy. This progressive, often painful nerve condition causes suffering and disability and also predisposes patients to developing musculoskeletal deformities and foot ulcers that may threaten life and limb. This chapter reviews briefly the significance of this condition, the underlying pathophysiology, and surgical considerations. Surgical decompression is a possible treatment for this neuropathy and may help prevent disastrous complications of diabetic peripheral neuropathy. However, foot surgery in the setting of diabetic peripheral neuropathy also carries significant risks.
13
Warwick, David, Roderick Dunn, Erman Melikyan, and Jane Vadher. Nerves. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199227235.003.0011.
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Neuroanatomy 298Examination of the nerves of the upper limb 300Clinical assessment 304Neurophysiology tests 306Nerve injury 310Compression neuropathy 314Carpal tunnel syndrome 315Proximal compression of the median nerve 318Anterior interosseous nerve syndrome 319Ulnar nerve compression at the elbow ...
14
Cohen, Jeffrey A., Justin J. Mowchun, Victoria H. Lawson, and Nathaniel M. Robbins. A 35-Year-Old Man with Progressive Left-Hand Weakness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190491901.003.0001.
Full textAbstract:
Multifocal motor neuropathy (MMN) may be mistaken for common entrapment neuropathies, although absence of significant sensory findings is a helpful clue to the diagnosis. Multifocal motor neuropathy may also mimic motor neuron disease. Electrophysiological evidence of conduction block at a nerve site not typically prone to compression is consistent with MMN. A positive anti-GM1 antibody also supports the diagnosis. First-line treatment of MMN is intravenous immunoglobulin (IVIG), and the majority of patients have rapid improvement of their weakness. The clinical features, differential diagnosis, investigations, and treatment options are described in this chapter.
15
Lavergne, Pascal, and Hélène T. Khuong. Neurogenic Thoracic Outlet Syndrome. Edited by Meghan E. Lark, Nasa Fujihara, and Kevin C. Chung. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190617127.003.0008.
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Neurogenic thoracic outlet syndrome is an entrapment neuropathy involving the brachial plexus along its trajectory from the cervical spine to the axilla. Clinical presentation includes cervical and upper extremity pain as well as neurologic signs and symptoms in the lower trunk territory. Radiologic and electrophysiologic studies are helpful adjuncts in correctly identifying the site of compression. Initial management is usually conservative, with medication, physical therapy, nerve blocks, or botulinum toxin injection. Surgery often consists of brachial plexus neurolysis and removal of compression points through the supraclavicular approach. Good outcomes can be expected with careful patient selection, but available literature is of limited quality.
16
Shaibani, Aziz. Numbness. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199898152.003.0023.
Full textAbstract:
Sensory symptoms are the most common symptoms in neuromuscular clinics, yet it is difficult to capture them in videos unless they have a very specific pattern and/or they are associated with objective loss of sensation. Distal sensory loss is a common neuropathic finding. Sensory neuropathies may also present with ataxia or severe pain. Multifocal sensory loss is usually vascular (vasculitis, diabetic amyotrophy). Intercostal pain and numbness are due to radiculopathy (diabetic, zoster, or compressive radiculopathy). Thoracic and abdominal radiculopathies are often misdiagnoses as acute coronary or abdominal emergencies respectively. The distribution of pain and the associated tingling and skin sensitivity to touch are important clues to their neuropathic nature.
17
Bolash, Robert B., and Kenneth B. Chapman. Piriformis Muscle Injections: Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0046.
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Piriformis syndrome is an entrapment neuropathy caused by compression or irritation of the sciatic nerve as it courses in proximity to the piriformis muscle. Conservative treatment modalities for piriformis syndrome include the use of anti-inflammatory analgesic medications or muscle relaxants. Physical therapy is often employed to correct the abnormal pelvic biomechanics and focus on stretching the piriformis muscle. Prior to proceeding with invasive surgical approaches, this chapter advocates the use of piriformis muscle injection. The technique both confirms the diagnosis and offers therapeutic value while avoiding the risks, expense, and potential adverse outcomes associated with surgical interventions. A combined fluoroscopic and nerve stimulator guided technique is recommended to identify bony landmarks, verify the perisciatic location, confirm intramuscular spread of the injectate, and avoid intravascular injection of particulate steroid. Transient sciatic nerve block caused by spillover of the local anesthetic administered into the piriformis muscle is a common complication.
18
Hoskin, Peter J. Radiotherapy in symptom management. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0123.
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Radiotherapy has a major role in symptom control and over 40% of all radiation treatments are given with palliative intent. In the palliative setting, radiotherapy will usually be delivered using high-energy external beam treatment from a linear accelerator. Bone metastases may be treated with intravenous systemic radioisotopes and dysphagia with endoluminal brachytherapy. A general principle of palliative radiotherapy is that it should be delivered in as few treatment visits as possible and be associated with minimal acute toxicity. The main indications for palliative radiotherapy are in the management of symptoms due to local tumour growth and infiltration. These include pain from bone metastases, visceral pain from soft tissue metastases, and neuropathic pain from spinal, pelvic, and axillary tumour. Local pressure symptoms are particularly onerous and potentially dangerous when they affect the nervous system; thus spinal canal compression remains one of the few true emergency situations in which radiotherapy is indicated. Similarly brain, meningeal, or skull base metastases require urgent assessment and can be helped with local radiotherapy. Obstruction of a hollow tube or drainage channels can lead to significant symptoms and again local radiotherapy can be valuable in addressing this scenario. Such indications would include dysphagia, bronchial obstruction, leg or arm oedema, vena cava obstruction, or hydrocephalus. Finally haemorrhage can be distressing if rarely life-threatening. Local radiotherapy to bleeding tumours in the lung, bronchus, bowel, genitourinary tract, and skin is very effective at control of bleeding.