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Neurosurgical Review Feb 2023The radial nerve is the biggest branch of the posterior cord of the brachial plexus and one of its five terminal branches. Entrapment of the radial nerve at the elbow is... (Review)
Review
The radial nerve is the biggest branch of the posterior cord of the brachial plexus and one of its five terminal branches. Entrapment of the radial nerve at the elbow is the third most common compressive neuropathy of the upper limb after carpal tunnel and cubital tunnel syndromes. Because the incidence is relatively low and many agents can compress it along its whole course, entrapment of the radial nerve or its branches can pose a considerable clinical challenge. Several of these agents are related to normal or variant anatomy. The most common of the compressive neuropathies related to the radial nerve is the posterior interosseus nerve syndrome. Appropriate treatment requires familiarity with the anatomical traits influencing the presenting symptoms and the related prognoses. The aim of this study is to describe the compressive neuropathies of the radial nerve, emphasizing the anatomical perspective and highlighting the traps awaiting physicians evaluating these entrapments.
Topics: Humans; Radial Neuropathy; Radial Nerve; Nerve Compression Syndromes; Upper Extremity; Elbow Joint
PubMed: 36781706
DOI: 10.1007/s10143-023-01944-2 -
The Orthopedic Clinics of North America Apr 2022Radial nerve injury with humeral shaft fracture is common. Treatment options include expectant management, early exploration and repair, delayed reconstruction, nerve... (Review)
Review
Radial nerve injury with humeral shaft fracture is common. Treatment options include expectant management, early exploration and repair, delayed reconstruction, nerve transfers, and tendon transfers. Knowledge of the appropriate application of these treatments will assist orthopedic surgeons and nerve surgeons in coordinating care for these patients.
Topics: Humans; Humeral Fractures; Humerus; Radial Nerve; Radial Neuropathy; Tendon Transfer
PubMed: 35365259
DOI: 10.1016/j.ocl.2022.01.001 -
Muscle & Nerve Aug 2021Acute hepatic porphyrias are inherited metabolic disorders that may present with polyneuropathy, which if not diagnosed early can lead to quadriparesis, respiratory... (Review)
Review
Acute hepatic porphyrias are inherited metabolic disorders that may present with polyneuropathy, which if not diagnosed early can lead to quadriparesis, respiratory weakness, and death. Porphyric neuropathy is an acute to subacute motor predominant axonal neuropathy with a predilection for the upper extremities and usually preceded by a predominantly parasympathetic autonomic neuropathy. The rapid progression and associated dysautonomia mimic Guillain-Barré syndrome but are distinguished by the absence of cerebrospinal fluid albuminocytologic dissociation, progression beyond 4 wk, and associated abdominal pain. Spot urine test to assess the porphyrin precursors delta-aminolevulinic acid and porphobilinogen can provide a timely diagnosis during an acute attack. Timely treatment with intravenous heme, carbohydrate loading, and avoidance of porphyrinogenic medications can prevent further neurological morbidity and mortality.
Topics: Aminolevulinic Acid; Guillain-Barre Syndrome; Humans; Peripheral Nervous System Diseases; Polyneuropathies; Porphobilinogen Synthase; Porphyrias, Hepatic; Radial Nerve
PubMed: 33786855
DOI: 10.1002/mus.27232 -
Handbook of Clinical Neurology 2024Radial neuropathy is the third most common upper limb mononeuropathy after median and ulnar neuropathies. Muscle weakness, particularly wrist drop, is the main clinical... (Review)
Review
Radial neuropathy is the third most common upper limb mononeuropathy after median and ulnar neuropathies. Muscle weakness, particularly wrist drop, is the main clinical feature of most cases of radial neuropathy, and an understanding of the radial nerve's anatomy generally makes localizing the lesion straightforward. Electrodiagnosis can help confirm a diagnosis of radial neuropathy and may help with more precise localization of the lesion. Nerve imaging with ultrasound or magnetic resonance neurography is increasingly used in diagnosis and is important in patients lacking a history of major arm or shoulder trauma. Radial neuropathy most often occurs in the setting of trauma, although many other uncommon causes have been described. With traumatic lesions, the prognosis for recovery is generally good, and for patients with persistent deficits, rehabilitation and surgical techniques may allow substantial functional improvement.
Topics: Humans; Radial Neuropathy; Radial Nerve
PubMed: 38697735
DOI: 10.1016/B978-0-323-90108-6.00015-6