1/24. Proximal Martin-Gruber anastomosis mimicking ulnar neuropathy at the elbow.We present a case of Martin-Gruber anastomosis (MGA) mimicking conduction block between the above- and below-elbow sites of ulnar nerve stimulation. We review the anatomical and electrophysiological literature on this subject and discuss its clinical implications. The potential for a MGA to occur very proximally in the forearm and thus mimic ulnar neuropathy at the elbow is underrecognized. We recommend that a check for MGA be performed on all patients with an apparent conduction block at the elbow, and suggest that 3 cm distal to the medial epicondyle may be an optimal below-elbow ulnar nerve stimulation site.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
2/24. Ulnar neuropathy as a complication of macular hole surgery.OBJECTIVE: To report a series of patients manifesting ulnar neuropathy as an extraocular complication following macular hole surgery and facedown positioning. methods: Retrospective chart review of 7 patients identified by the operating surgeon as developing ulnar neuropathy during the immediate postoperative period after undergoing vitrectomy surgery with fluid-gas exchange for macular hole followed by at least 1 week of strict facedown positioning. RESULTS: All 7 patients developed symptoms of ulnar neuropathy, including paresthesias, dysesthesias, pain, weakness, and muscle atrophy. Signs included abnormal electromyogram, prolonged nerve conduction velocities, and impaired neurologic clinical test results in patients examined. Symptoms did not resolve with cessation of facedown positioning, and with follow-up ranging from 3 to 24 months all patients had persistent symptoms. All patients had positioned themselves with their arms continuously flexed. Three of 7 patients had placed pressure directly on their bent elbows. CONCLUSIONS: Ulnar neuropathy is an extraocular complication of macular hole surgery that can be attributed to arm position during postoperative facedown positioning. Surgeons performing macular hole surgery should caution their patients to minimize the amount of time spent with their elbows in a flexed position. Particular effort should be made to minimize pressure on the bent elbow.- - - - - - - - - - ranking = 1.6keywords = neuropathy (Clic here for more details about this article) |
3/24. Motor neuron presentation of an ulnar neuropathy and Riche-Cannieu anastomosis.A Riche (7)-Cannieu (2) anastomosis (ulnar-to-median anastomosis in the hand) in the setting of an ulnar or median nerve lesion can produce confusing clinical and electrodiagnostic findings. We report a patient with a deep branch ulnar neuropathy complicated by a Riche-Cannieu anastomosis. His clinical presentation led to an initial diagnosis of motor neuron disease. Extensive electrophysiologic studies clarified the extent of the Riche-Cannieu anastomosis and the ulnar neuropathy.- - - - - - - - - - ranking = 1.2000002883579keywords = neuropathy, deep (Clic here for more details about this article) |
4/24. MRI in unexplained mononeuropathy.Four young patients with severe unexplained progressive mononeuropathy are described. None had a history of known trauma to the affected limb. In addition to the standard neurologic examination and electrophysiologic studies (nerve conduction studies and electromyography), all underwent neuroimaging of the involved extremity. In three patients, magnetic resonance imaging revealed intrinsic abnormalities of the appropriate nerve. The pattern or absence of magnetic resonance imaging changes directly influenced decisions about surgical exploration of the nerve in all four patients. With the advent of more sophisticated technology, magnetic resonance neurography has become a potent diagnostic tool in the evaluation of disorders of peripheral nerve and muscle.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
5/24. Ulnar neuropathy at the elbow due to unusual sleep position.Abnormal strain of the ulnar nerve over the sulcus due to an unusual sleep position is a rare cause of ulnar neuropathy at the elbow. A 57-year-old patient with Mandelung's deformity developed progressive weakness in the flexion of fingers 4 and 5 and in finger straddling on the left side. Additionally, there was slight wasting of the left hypothenar and the left interossei muscles. Motor and sensory nerve conduction studies of the left ulnar nerve showed delayed conduction velocities over the left ulnar sulcus. He preferred to sleep in a left lateral position with his head lying on a headrest roll, his left forearm being flexed at 110 degrees and his hand lying either under his cheek or placed on the roll. Only three weeks after the patient had been advised to change his sleep position and to sleep without the headrest roll, weakness markedly improved. This case shows that sleeping in a lateral position with the head on a headrest roll and the hand placed on the roll or under the cheek may cause ulnar neuropathy at the elbow. Change of such a habitual sleep position promptly resolves the symptoms.- - - - - - - - - - ranking = 1.2keywords = neuropathy (Clic here for more details about this article) |
6/24. Ulnar neuropathy resulting from diffuse intramuscular hemorrhage: a case report.The ulnar nerve can be injured in the arm, forearm, and wrist. This report describes a 79-year-old woman who presented to the emergency department with acute lower extremity weakness and vertigo. Her medical history was significant for moderate to severe aortic stenosis, hypertension, and a remote intravascular thrombosis in the right forearm. The patient was diagnosed with a transient ischemic attack and was treated with anticoagulants. Three days after beginning anticoagulation therapy, she developed a diffuse intramuscular hemorrhage in the arm, which compromised predominantly ulnar fibers. The clinical, radiologic, and electrodiagnostic abnormalities are reviewed, and the possible etiologies of ulnar neuropathy are discussed. To our knowledge, this is the first report of ulnar neuropathy secondary to diffuse hemorrhage into the muscles of the arm.- - - - - - - - - - ranking = 1.2keywords = neuropathy (Clic here for more details about this article) |
7/24. Telesales neuropathy.A case of bilateral ulnar neuropathies caused by overuse of the telephone is described in a 17 year old double glazing salesman. The importance of taking a good occupational history is emphasised and the need for correct staff training and appropriate equipment highlighted.- - - - - - - - - - ranking = 0.8keywords = neuropathy (Clic here for more details about this article) |
8/24. minocycline-associated lupus-like syndrome with ulnar neuropathy and antiphospholipid antibody.Peripheral neuropathy in association with minocycline-induced lupus-like reaction has not previously been reported. We present a case of probable minocycline-induced lupus associated with antiphospholipid antibodies and an ulnar neuropathy which has slowly improved since the discontinuation of minocycline.- - - - - - - - - - ranking = 1.2keywords = neuropathy (Clic here for more details about this article) |
9/24. 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 = 0.2keywords = neuropathy (Clic here for more details about this article) |
10/24. Intraneural nerve metastasis with multiple mononeuropathies.Although cancer is a frequent condition, neoplastic involvement of the peripheral nervous system is rare. The mechanisms are heterogeneous and include lesions within the cerebrospinal fluid (CSF) space, local invasion (e.g. brachial plexus), compression, rarely direct infiltration, perineurial spread and even rarer intranerval metastasis. A 47-year-old woman had been treated for a carcinoid 10 years earlier and had received axillar irradiation. At presentation she suffered from weakness of the biceps brachii and was experiencing pain radiating from the axilla into the forearm and thumb. MR scans of the brachial plexus were negative and her symptoms were primarily considered to stem from a postradiation brachial plexopathy, Because of increasing pain, the brachial plexus was explored and a metastasis in the left musculocutaneous nerve was resected. Several months later, numbness and pain appeared in the ulnar nerve and another intrafascicular metastasis in the ulnar nerve was discovered. Resection with preservation of remaining fascicles was performed. This rare case report demonstrates that multiple mononeuropathies, resembling multiplex neuropathy, may be caused by intranerval metastasis.- - - - - - - - - - ranking = 0.2keywords = neuropathy (Clic here for more details about this article) |
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