1/14. Compression neuropathy of the superficial branch of the radial nerve. case reports.We present two cases of hypoaesthesia over the dorsal radial aspect of the hand with an associated painful mass in the wrist. At operation a dorsal wrist ganglion was compressing the superficial branch of the radial nerve at the anatomical snuff-box. After removal of the ganglion the hypoaesthesia was relieved.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
2/14. Migrant sensory neuropathy: report of 5 cases and review of the literature.There are only a few case descriptions of migrant sensory neuropathy. We report the clinical, laboratory, and electrophysiological findings observed in 5 patients whose presentation conformed with Wartenberg's description of a chronic, disseminated migrant sensory mononeuritis. In one patient, intermittent cranial motor nerve involvement occurred as well. The sural nerve biopsy in this patient showed changes suggestive of focal ischemic nerve damage and electron microscopy confirmed a vasculopathy.- - - - - - - - - - ranking = 1.25keywords = neuropathy (Clic here for more details about this article) |
3/14. Radial entrapment neuropathy due to chronic injection-induced triceps fibrosis.We report two patients who developed progressive, severe, painless radial neuropathies (bilateral in one, unilateral in the other) as a delayed complication of chronic intramuscular analgesic injection. In each instance, exploration of the radial nerve revealed multifocal entrapment within a densely fibrotic triceps muscle at sites between the spiral groove and distal course of the radial nerve near the elbow. Release of the nerve from constriction within the fibrotic triceps muscle produced improvement in all three affected nerves.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
4/14. Bilateral transient radial nerve palsies in an infant after cardiac surgery.PURPOSE: To describe the case of an infant who suffered bilateral transient radial nerve palsies after cardiac surgery. CLINICAL FEATURES: A one-month-old baby was found to have bilateral wrist and finger drop after the removal of splints that has been applied to the right hand for 14 days and to the right hand for six days during perioperative management of Blalock-Taussig shunt surgery. The hand splints had been applied to the forearms with adhesive silky tape to keep peripheral vascular lines in place. The patient also suffered from several episodes of cardiogenic shock, hypoxemia and generalized edema relating to cardiac dysfunction during this fine period. Given the findings of no impairment of median or ulnar nerves and brachioradial muscle, it was suspected that bandaging with adhesive tapes caused peripheral radial nerve damage at the level of posterior interosseus nerve on forearm. Diminished oxygen delivery and edema may additionally have contributed to peripheral nerve ischemia. The aforementioned neurologic symptoms resolved spontaneously after several days. CONCLUSION: Prolonged compression by bandaging of splints on forearm may have resulted in ischemic damage to the posterior interosseus nerve branch combined with extensor carpi radialis longus nerve branch of the radial nerve. We should attempt to reduce the frequency and duration of splinting of the extremities, especially in sedated, paralyzed babies, given the potential risk of compression neuropathy.- - - - - - - - - - ranking = 0.25keywords = neuropathy (Clic here for more details about this article) |
5/14. Focal myopathy mimicking posterior interosseous nerve syndrome.A 25-year-old man developed weakness of extension of the right index, middle, and fourth fingers at the metacarpophalangeal joints, over 2 years. No sensory deficit was present. Nerve conduction studies, including the right radial nerve, were within normal limits. Needle electromyographic (EMG) examination showed myopathic changes that were limited to the right extensor digitorum communis and extensor indicis proprius muscles. An intravenous edrophonium chloride test had no effect on weakness and repetitive stimulation showed no significant decremental response. An EMG-guided open biopsy of the extensor digitorum communis muscle revealed severe myopathic changes. Evaluation for the cause of myopathic involvement was negative. After 13 months, clinical examination and electrophysiological studies showed no significant progression. This case exemplifies the fact that a focal myopathy may mimic an entrapment neuropathy.- - - - - - - - - - ranking = 0.25keywords = neuropathy (Clic here for more details about this article) |
6/14. Porphyria presenting with bilateral radial motor neuropathy: evidence of a novel gene mutation.The authors identified a novel mutation of the porphobilinogen deaminase (PBG-D) gene in a patient with acute intermittent porphyria presenting with severe and bilateral axonal radial motor neuropathy. Electrophysiologic studies revealed prominent involvement of distal radial nerves in the setting of mild polyneuropathy. Analysis of the PBG-D gene revealed a single base-pair insertion (887insA) in exon 14.- - - - - - - - - - ranking = 1.5keywords = neuropathy (Clic here for more details about this article) |
7/14. Radial tunnel syndrome in an elite power athlete: a case of direct compressive neuropathy.Radial tunnel syndrome (RTS) is thought to result from intermittent and dynamic compression of the posterior interosseous nerve (PIN) in the proximal part of the forearm associated with repeated supination and pronation. The diagnostic criteria encompassing RTS are purely clinical and the term "radial tunnel syndrome" has become controversial because of the lack of focal motor weakness in the majority of patients diagnosed with RTS. Retrospective cadaveric and surgical studies have revealed several areas within the forearm in which the PIN may become entrapped. Recent studies have suggested that the PIN is "fixed" in the supinator muscle and that wrist pronation is the actual movement that places the most stress on the PIN. The patients most often afflicted with RTS appear to be those who perform repetitive manual tasks involving rotation of the forearm and athletes involved in racket sports. Surgical exploration with decompression of the PIN is often required in patients with RTS. We present the first case of RTS occurring in an elite power athlete and believe this case represents a direct compressive sensory neuropathy. The optimum nonsurgical treatment plan for the elite athlete in training for competition and the cause of this compressive neuropathy in power athletes will be discussed.- - - - - - - - - - ranking = 1.5keywords = neuropathy (Clic here for more details about this article) |
8/14. Bed footboard peroneal and tibial neuropathy. A further unusual type of Saturday night palsy.An uncommon cause of bilateral tibial and peroneal compression neuropathy is reported. After taking alcohol and drugs, a young heroin-addicted man lay unconscious overnight in supine position, with both legs crossing the wooden board at the end of the bed, the posterior aspect of the flexed knees pressing against its edge. The following day, he had weakness of foot flexion and extension and a sensory loss consistent with a bilateral tibial and peroneal neuropathy. Symptoms resolved rapidly in the left side; in the right side, a conduction block was still demonstrable 3 weeks later.- - - - - - - - - - ranking = 1.5keywords = neuropathy (Clic here for more details about this article) |
9/14. radial nerve palsy owing to localized hypertrophic neuropathy (intraneural perineurioma) in early childhood.Localized hypertrophic neuropathy, also termed intraneural perineurioma, is a rare disorder of unknown etiology that produces a slowly progressive painless focal lesion of a peripheral nerve. It is characterized histologically by concentric whorls ("onion bulbs") of epithelial membrane antigen-reactive, S-100 protein-negative perineurial cells surrounding nerve fibers. We report a radial nerve palsy in a child aged 2 years in whom the diagnosis of localized hypertrophic neuropathy was made by biopsy. Resection of the affected nerve segment and sural nerve grafting produced no useful recovery after 3 years, probably because of the long duration of denervation. When this mononeuropathy presents in early childhood, uncertainty over the time of onset can lead to difficulty in distinguishing this potentially treatable lesion from congenital and other causes of nerve palsy.- - - - - - - - - - ranking = 1.75keywords = neuropathy (Clic here for more details about this article) |
10/14. Compression neuropathy of the radial palmar thumb nerve.Compression neuropathy of a single digital nerve is a rare entity. We report the case of a patient with numbness in the distribution of the radial digital nerve of the thumb caused by the use of a walking stick. The nerve was compressed between the handle of the stick, the loop and the radial sesamoid bone of the first metacarpophalangeal joint. The site of the lesion was confirmed by electrophysiologic examination. Orthodromic recording of the sensory response from the radial palmar digital nerve of the thumb documented a complete absence of nerve action potential whereas the ulnar digital thumb nerve showed a normal response. Sensory function was restored when a padded ski glove was used to protect the area of the metacarpophalangeal joint whilst using the stick.- - - - - - - - - - ranking = 1.25keywords = neuropathy (Clic here for more details about this article) |
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