Entrapment neuropathies

Current Opinion in Neurology

Volumn 12, Issue 5, 1999, Pages 597-602

  England, John D ^a  

^a Louisiana State School of Dentistry   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

PREDNISOLONE; STEROID; TENOXICAM; TRICHLORMETHIAZIDE;

CARPAL TUNNEL SYNDROME; HUMAN; NERVE COMPRESSION; PERIPHERAL NERVE; PERIPHERAL NEUROPATHY; REVIEW; STEROID THERAPY; THORAX OUTLET SYNDROME;

CARPAL TUNNEL SYNDROME; DIAGNOSIS, DIFFERENTIAL; HUMANS; NERVE COMPRESSION SYNDROMES; PERIPHERAL NERVOUS SYSTEM DISEASES; THORACIC OUTLET SYNDROME;

EID: 0033381714     PISSN: 13507540     EISSN: None     Source Type: Journal    
DOI: 10.1097/00019052-199910000-00014     Document Type: Review

References (34)

1. 1 Gilliatt RW. Chronic nerve compression and entrapment. In: The physiology of peripheral nerve disease, 1st ed. Sumner AJ (editor). Philadelphia: WB Saunders Company; 1980. pp. 316-339.
2. 2 Thomas PK, Holdorff B. Neuropathy due to physical agents. In: Peripheral neuropathy. 3rd ed. Dyck PJ, Thomas PK, Griffin JW, Low PA, Poduslo JF (editors). Philadelphia: WB Saunders Company; 1993. pp. 990-1013.
3. 3 Stewart JD. Focal peripheral neuropathies, 2nd ed. New York: Raven Press; 1993.
4. 4 Kline DG, Hudson AR. Nerve injuries, operative results for major nerve injuries, entrapments, and tumors, 1st ed. Philadelphia: WB Saunders Company; 1995.
5. 5 Scelsa SN, Herskovitz S, Bieri P, Berger AR. Median mixed and sensory nerve conduction studies in carpal tunnel syndrome. Electroenceph Clin Neurophysiol 1998; 109:268-273. This study reports the relative sensitivity and specificity of different NCSs in the diagnosis of CTS. The comparison of the median conduction in the palm to wrist segment with the median conduction in the palm to digit two segment provided the most sensitive test.
6. 6 Bureau of Labor Statistics. Work injuries and illnesses by selected characteristics, 1992. Washington, DC: Bureau of Labor Statistics, US Dept of Labor publication; 1994. pp. 94-213.
7. 7 Bureau of Labor Statistics. Characteristics of injuries and illnesses resulting in absences from work, 1994. Washington, DC: Bureau of Labor Statistics, US Dept of Labor publication; 1996. pp. 96-163.
8. 8 Nathan PA, Keniston RC, Myers LD, Meadows KD, Lockwood RS. Natural history of median nerve sensory conduction in industry: relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years. Muscle Nerve 1998; 21:711-721. Median nerve sensory conduction and the development of CTS was followed prospectively in 289 workers over 11 years. Although there was a trend for median sensory latencies to increase over time, the prevalence of hand symptoms actually decreased, and the prevalence of CTS remained unchanged. The authors concluded that slowing of median nerve sensory conduction occurs naturally with increasing age, and does not necessarily correlate with symptoms of CTS. The majority of workers did not develop median nerve slowing or clinically evident CTS. Of course, it would be nice to know whether the prevalence of median sensory slowing in these workers is the same or greater than an age-matched population of nonindustrial workers.
9. 9 Atcheson SG, Ward JR, Lowe W. Concurrent medical disease in work-related carpal tunnel syndrome. Arch Intern Med 1998; 158:1506-1512. Work-related CTS is reported to account for more than 41% of all repetitive motion disorders in the USA. This study evaluated 297 patients who had been medically certified to have a work-related upper extremity disorder. Although 198 of these individuals had been diagnosed as having work-related CTS, most of them had not been adequately evaluated for concomitant diseases that are associated with CTS. Upon repeat evaluation, up to two-thirds of them had other medical conditions (especially diabetes, hypothyroidism, and obesity) that may have caused their CTS. True work-related CTS may not be as prevalent as previously thought, because most studies have not excluded concurrent medical illnesses.
10. ••] calls for better, prospective, controlled studies to assess the association of occupational hand use and CTS. I agree that the true degree of association is not known.
11. 11 Chang MH, Chiang HT, Lee SSJ, Ger LP, Lo YK. Oral drug of choice in carpal tunnel syndrome. Neurology 1998; 51:390-393. Patients with electrodiagnostically confirmed mild-to-moderate CTS were given 4 weeks of either placebo, diuretic, nonsteroidal anti-inflammatory drug, or prednisolone orally. At the end of the study, only the patients who had received prednisolone reported a significant reduction in symptoms. Thus, short-term, low-dose oral steroids may be beneficial for mild-to-moderate CTS. However, whether steroids improve nerve conduction parameters or produce long-term benefit is unknown. I suspect that the benefit is short-term with eventual recrudescence of symptoms in most patients.
12. 12 Jimenez DF, Gibbs SR, Clapper AT. Endoscopic treatment of carpal tunnel syndrome: a critical review. J Neurosurg 1998; 88:817-826. This is a very complete review of the endoscopic carpal tunnel release procedures. Critical comparisons among the different endoscopic techniques are provided. When endoscopic carpal tunnel releases are performed by experienced surgeons, the success and complication rates are similar to those for standard open carpal tunnel release procedures. In some cases the endoscopic procedure may be superior because many patients who undergo this procedure experience less pain and return to work and other activities earlier.
13. 13 Okutsu I, Ninomiya S, Natsuyama M, Takatori Y, Inanami H, Kuroshima N, Hiraki S. Subcutaneous operation and examination under universal endoscope. J Jpn Orthop Assoc 1987; 61:491-498.
14. 14 Okutsu I, Ninomiya S, Takatori Y. Results of endoscopic management of carpal tunnel syndrome. Orthop Rev 1993; 22:81-87.
15. •].
16. •] debate the spectrum of thoracic outlet syndrome. Both authors agree that there is a well defined 'classic' true neurogenic thoracic outlet syndrome. In my mind, Dr Wilbourn's arguments are more in line with the scientific approach to the subject.
17. 17 Gilliart RW, LeQuesne PM, Logue V, Sumner AJ. Wasting of the hand associated with a cervical rib or band. J Neurol Neurosurg Psychiatry 1970; 33:615-624.
18. 18 Levin KH, Wilbourn AJ, Maggiano HJ. Cervical rib and median sternotomy-related brachial plexopathies. A reassessment. Neurology 1998; 50:1407-1413. I believe that this is one of the most interesting clinical electrophysiology papers of the past year. The authors studied one group of patients with true neurogenic thoracic outlet syndrome and another group of patients with sternotomy-related 'brachial plexopathy'. They utilized standard electrophysiologic studies, but also performed medial antebrachial cutaneous sensory NCSs on all patients. The medial antebrachial cutaneous sensory nerve probably receives a greater T1 root contribution than the ulnar sensory nerve, which is derived primarily from C8 root fibers. The medial antebrachial cutaneous nerve was always the most affected nerve in the patients with thoracic outlet syndrome, whereas the ulnar sensory and motor nerves were the most affected in the patients with sternotomy-related 'brachial plexopathy'. The results imply that the site of injury in these disorders is not really at the lower trunk of the brachial plexus, but at the level of the anterior primary rami of the distal T1 and C8 roots. Performing a medial antebrachial cutaneous NCS is relatively easy, and I would suggest that electromyographers perform this study when evaluating possible 'brachial plexus' disorders.
19. 19 Stricker T, Steinlin M, Willi UV, Nadal D. Hypoglossal nerve palsy associated with deep cervical lymphadenopathy. Neurology 1998; 50:1926-1927.
20. 20 Mondelli M, Cioni R, Federico A. Rare mononeuropathies of the upper limb in bodybuilders. Muscle Nerve 1998; 21:809-812.
21. 21 England JD, Tiel RL. AAEM case report 33: costoclavicular mass syndrome. Muscle Nerve 1999; 22:412-418. Clavicular fractures generally heal without complication. The patient reported here developed a compressive brachial plexopathy secondary to excessive callus formation associated with a healing displaced midclavicular fracture. The brachial plexus became entrapped between the clavicle and the first rib. The electromyographic and neuroradiologic findings are well documented in the paper. Physicians should be aware of this complication of clavicular fractures because it is a potentially preventable and treatable problem.
22. 22 Lenssen PPA, Gabreels-Festen AAWM, Valentijn LJ, Jongen PJH, van Beersum SEC, van Engelen BGM, et al. Hereditary neuropathy with liability to pressure palsies. Phenotypic differences between patients with the common deletion and a PMP22 frame shift mutation. Brain 1998; 121:1451-1458. Most cases of HNPP are due to a deletion of the gene that codes for the peripheral myelin protein peripheral myelin protein-22. This paper describes the phenotype of 23 patients from six families who had a frame-shift mutation of the PMP22 gene and not a deletion. They showed many of the same clinical and electrophysiologic features of common HNPP, but in addition they had more generalized neuropathic features that mimicked Charcot-Marie-Tooth disease type 1.
23. 23 Pareyson D, Solari A, Taroni F, Botti S, Fallacia E, Scaioli V, et al. Detection of hereditary neuropathy with liability to pressure palsies among patients with acute painless mononeuropathy or plexopathy. Muscle Nerve 1998; 21:1686-1691. Keys to the diagnosis of HNPP included recurrent transient neuropathies (especially brachial plexopathy), and clinical or electrophysiologic involvement of several nerves.
24. 24 Stogbauer F, Young P, Kerschensteiner M, Ringelstein EB, Assmann G, Funke H. Recurrent brachial plexus palsies as the only clinical expression of hereditary neuropathy with liability to pressure palsies associated with a de novo deletion of the peripheral myelin protein-22 gene. Muscle Nerve 1998; 21:1199-1201. The title of this paper says it all.
25. 25 Parry GJ, Clarke S. Pure motor neuropathy with multifocal conduction block masquerading as motor neuron disease. Muscle Nerve 1988; 11:103-109.
26. 26 Beydoun SR. Multifocal motor neuropathy with conduction block misdiagnosed as multiple entrapment neuropathies. Muscle Nerve 1998; 21:813-815. This patient underwent several unnecessary surgeries because the condition was not recognized. Unfortunately, thorough electrophysiologic assessment by a competent electrodiagnostic consultant was not performed until after these operations had been done.
27. 27 Chaudhry V, Corse A, Cornblath DR, Kuncl RW, Drachman DB, Freimer ML, et al. Multifocal motor neuropathy: response to human immune globulin. Ann Neurol 1993; 33:237-242.
28. 28 England JD. The variations of neuralgic amyotrophy [editorial]. Muscle Nerve 1999; 22:435-436. This editorial summarizes the current thinking about this condition, which also goes by the eponym Parsonage-Turner syndrome. Occasionally, this condition is mistaken for compressive or entrapment neuropathies.
29. 29 Maravilla KR, Bowen BC. Imaging of the peripheral nervous system: evaluation of peripheral neuropathy and plexopathy. Am J Neuroradiol 1998; 19:1011-1023. This excellent review covers state-of-the-art MRI of the peripheral nervous system.
30. 30 Quencer RM. The next frontier in neuroradiology: Imaging the peripheral nervous system [editorial]. Am J Neuroradiol 1998; 19:1001.
31. 31 Loredo R, Hodler J, Pedowitz R, Yen L-R, Trudell D, Resnick D. MRI of the common peroneal nerve: normal anatomy and evaluation of masses associated with nerve entrapment. J Comput Assist Tomogr 1998; 22:925-931. This paper illusrtates the magnetic resonance appearances of normal and pathologic peroneal nerves.
32. 32 Uetani M, Hashmi R, Hayashi K, Nagatani Y, Narabayashi Y, Imamura K. Peripheral nerve intraneural ganglion cyst: MR findings in three cases. J Comput Assist Tomogr 1998; 22:629-632. These cysts, which are nicely demonstrated by magnetic resonance, are typically located along the course of a nerve near a synovial joint. They can be quite long, with a length of 2-15 cm.
33. 33 Helms CA, Martinez S, Speer KP. Acute brachial neuritis (Parsonage-Turner syndrome): MR imaging appearance - report of three cases. Radiology 1998; 207:255-259. This paper provides information on the magnetic resonance appearance of denervated muscles.
34. 34 Grainger AJ, Campbell RSD, Stothard J. Anterior interosseous nerve syndrome: appearance at MR imaging in three cases. Radiology 1998; 208:381-384. This is another paper that demonstrates the magnetic resonance appearance of denervated muscles.