1/10. Synovial osteochondromatosis at the elbow producing ulnar and median nerve palsy. Case report and review of the literature.The authors present the case of a 53-year-old woman suffering from synovial osteochondromatosis of her right elbow responsible for ulnar and median nerve entrapment neuropathy. This condition is characterised by the formation of multiple cartilaginous nodules in the metaplastic synovium of otherwise normal joints, bursae or tendon sheaths. Treatment consisted of partial synovectomy, removal of loose bodies and microscopic nerve release. Synovial osteochondromatosis complicated by nerve compression syndromes has been rarely reported, usually with ulnar tunnel syndrome at the elbow. The literature on this subject is reviewed.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
2/10. [Proximal neuropathy of the median nerve]In a 77 year old man the rare clinical picture of a complete lesion of the median nerve at the upper arm is described. During removal of a "neurinoma" at the upper arm, inadvertedly the general surgeon had also transsected the median nerve. However diagnosis was delayed due to electrodiagnostic tests, which erronously interpreted the volume conduction of the neigbouring nerves as partial function, and later even as improvement of the median nerve function.Clinically he presented with "orators" hand. He was unable to pinch thumb and index finger, Sensory loss was noted at the fingertip 2 and 3, atrophy of the abductor pollicis brevis muscle and trophic skin changes with an ulcer at the tip of the index finger.Nerve revision confirmed the median nerve transsection. Intraoperative nerve stimulation could not elicit distal muscle stimulation. sural nerve transplant was performed and within one year a positive Tinel sign progressing 20 cm distally to the operation site, without distal motor or sensory changes was observed.- - - - - - - - - - ranking = 4keywords = neuropathy (Clic here for more details about this article) |
3/10. Neuropathy of motor branch of median or ulnar nerve induced by midpalm ganglion.Two cases of neuropathy of a motor branch caused by a midpalmal ganglion are presented. In the first case the ganglion originated from the midcarpal joint, protruded into the thenar muscle, and compressed the motor branch of the median nerve. In the second case the ganglion, distal to the fibrous arch of the hypothenar muscles, originated from the third carpometacarpal joint and compressed the motor branch of the ulnar nerve. In both cases muscle weakness and finger deformity recovered well after resection of the ganglion. This clinical condition is rare compared with carpal tunnel syndrome and Guyon's tunnel syndrome, which are caused by a ganglion in the wrist.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
4/10. Postoperative edema after vascular access causing nerve compression secondary to the presence of a perineuronal lipoma: case report.OBJECTIVE AND IMPORTANCE: median nerve neuropathy can be clinically devastating to a patient. It can be caused by compression of the median nerve anywhere along its course. We present the case of delayed median nerve neuropathy after the placement of a vascular graft in the arm. CLINICAL PRESENTATION: An arm shunt was placed in the nondominant upper extremity in a 60-year-old man with end-stage renal disease. Twelve hours postoperatively, the patient developed neurapraxia in the median nerve distribution in the hand. INTERVENTION: Exploration of the arm revealed a lipoma coursing along and deep to the median nerve. Resection of the lipoma decompressed the nerve. CONCLUSION: In this patient, median nerve neuropathy was caused by a lipoma and postoperative swelling from placement of the vascular graft. The swelling that occurred after the shunt placement unmasked subclinical compression of the nerve by a lipoma deep to the median nerve. To our knowledge, this report is unique in documenting damage to the median nerve after vascular graft placement as a result of an occult mass.- - - - - - - - - - ranking = 3keywords = neuropathy (Clic here for more details about this article) |
5/10. Anterior interosseous nerve and multifocal motor neuropathy.We report the case of a 47-year-old woman with a left anterior interosseous nerve palsy. Surgical release of the anterior interosseous nerve was initially proposed, but electrodiagnostic evaluation demonstrated that the neuropathy was due not to compression or to neuralgic amyotrophy but to a proximal conduction block. At that time, the conduction block could be defined only by indirect electrodiagnostic criteria. A multifocal motor neuropathy with persistent conduction block was subsequently diagnosed, and the patient was treated with intravenous immunoglobulins. The efficacy of this treatment and the subsequent disclosure of conduction block in the right posterior interosseous and peroneal nerves definitively confirmed the multifocal motor neuropathy.- - - - - - - - - - ranking = 7keywords = neuropathy (Clic here for more details about this article) |
6/10. Entrapment neuropathy of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome: a case report.A case of the entrapment neuropathy of the palmar cutaneous branch of the median nerve, concomitant with carpal tunnel syndrome is presented. This report demonstrates that the Semmes-Weinstein monofilament test and nerve conduction studies can identify entrapment of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome.- - - - - - - - - - ranking = 5keywords = neuropathy (Clic here for more details about this article) |
7/10. Concomitant compression of median and ulnar nerves in a hemophiliac patient: a case report.A 15-year-old boy, with a diagnosis of hemophilia a, suffered bleeding into his left forearm 5 months before being admitted to our medical center. His neurological examination revealed a pronounced median neuropathy and a minor ulnar neuropathy on the left side. There was marked muscle atrophy on the thenar side and, to a lesser degree, on the hypothenar side and in the forearm. Electromyographic findings demonstrated an evident, nearly complete, sensorimotor axonal loss in the median nerve. magnetic resonance imaging studies showed atrophy in muscles of the left forearm and median nerve. The patient was diagnosed as having median nerve axonotmesis and ulnar nerve neuropraxia due to compartment syndrome. In hemophiliac patients, frequent single nerve compressions (often involving the femoral nerve) can be seen. However, concomitant median and ulnar nerve injuries with differing severity are rare.- - - - - - - - - - ranking = 2keywords = neuropathy (Clic here for more details about this article) |
8/10. Bilateral neurogenic thoracic outlet syndrome.We report a case of bilateral neurogenic thoracic outlet syndrome (TOS). Electrophysiological examination suggested the presence of bilateral lower brachial plexus neuropathy. radiography showed rudimentary bilateral cervical ribs. In the cases reported in the literature to date, the clinical findings are typically unilateral despite the common presence of bilateral bony abnormalities. Neurogenic TOS should be considered in young women, even if they present with bilateral symptoms, when they have occupations requiring strenuous activity of the upper limbs.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
9/10. Somatosensory evoked potentials for the diagnosis of proximal sensory median neuropathy with preserved distal sensory action potential.A 33 year-old-man with paresthesia in first three fingers of the right hand after minor trauma of the arm was examined electrophysiologically. The proximal sensory median neuropathy was isolated which it is unusual in traumatic lesion. Motor and distal sensory conduction studies were normal but sensory evoked potentials (SEPs) were abnormal by right median nerve stimulation at the wrist level with decrease in amplitude of peripheral potential at the Erb's point, the cervical and contralateral parietal levels. This pattern, preserved distal sensory action potential and abnormal peripheral SEPs were suggesting the presence of proximal sensory block conduction without wallerian degeneration. The recovery was complete and fast in correlation with the absence of axonopathy.- - - - - - - - - - ranking = 5keywords = neuropathy (Clic here for more details about this article) |
10/10. An unusual case of haemorrhagic median neuropathy.The authors describe a rare case of carpal tunnel syndrome secondary to intraneural haemorrhage of the median nerve.- - - - - - - - - - ranking = 4keywords = neuropathy (Clic here for more details about this article) |
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