-
Revue Medicale de Liege 2004When the anterior interosseous nerve (AIN) is involved, a motor deficit of the distal pinch appears. It usually occurred suddenly, with or without pain and the deficit... (Review)
Review
When the anterior interosseous nerve (AIN) is involved, a motor deficit of the distal pinch appears. It usually occurred suddenly, with or without pain and the deficit may be complete or partial. Other nerve lesions and some precipitating conditions can be noticed and are important to assess the exact mechanism of the nerve lesion. Partial AIN lesion is frequently misdiagnosed as tendon rupture. The electrodiagnostic examination should always study the pronator quadratus or another muscle innervated by the AIN, the AIN conduction and the motor and sensory median nerve conduction. Thus electrodiagnosis will always assess the AIN lesion and precise its axonal or compressive mechanism. Mononeuritis as neuralgic amyotrophy is the most frequent cause of AIN palsy and never requires surgery. Traumatic lesions are less frequent and usually recover spontaneously. Thus, surgery is rarely required before 12 to 18 months except when no recovery occurs after trauma.
Topics: Diagnosis, Differential; Humans; Median Nerve; Median Neuropathy; Neurophysiology
PubMed: 15244160
DOI: No ID Found -
American Family Physician Dec 2016
Topics: Carpal Tunnel Syndrome; Humans; Splints; Surgical Procedures, Operative
PubMed: 28075099
DOI: No ID Found -
Journal of Orthopaedics and... Jun 2023Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy. Menopausal status and/or estrogen level may play a role in CTS. The evidence regarding the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy. Menopausal status and/or estrogen level may play a role in CTS. The evidence regarding the association between hormone replacement therapy (HRT) in postmenopausal women and CTS is still conflicting. This meta-analysis aimed to investigate the association between carpal tunnel syndrome (CTS) and women using hormone replacement therapy (HRT).
METHODS
A search was conducted in the PubMed/Medline, Scopus, Embase, and Cochrane databases, from their inception through July 2022. Studies which reported on the association between any type of HRT use and the risk of developing CTS in postmenopausal women compared to a control group were included. Studies which did not include a control group were excluded. Of the 1573 articles extracted from database searches, seven studies involving 270,764 women were included of which 10,746 had CTS. The association between CTS and HRT use was evaluated using the pooled odds ratio (OR) with a 95% confidence interval (CI) under random-effects modelling. Risk of bias in each study was assessed using the Newcastle-Ottawa Scale (NOS) and version 2 of the Cochrane tool for assessing risk of bias in randomized trials (RoB 2).
RESULTS
HRT use showed no statistically significant association with a higher risk of CTS with pooled odds ratio (OR) 1.49, 95% confidence interval (CI) 0.99-2.23, and p = 0.06, although high heterogeneity among the studies was observed (I 97.0%, Q-test p-value < 0.001). Subgroup analysis of groups in non-randomized controlled studies showed a significantly increased risk of CTS, while groups in randomized controlled studies showed a decreased risk of CTS (pooled OR 1.87, 95% CI 1.24-2.83 versus pooled OR 0.79, 95% CI 0.69-0.92, respectively) with the p-value of group difference < 0.001. The risk of bias in most of the included studies was estimated to be low.
CONCLUSIONS
This meta-analysis supports the safety of using HRT in postmenopausal women with potential risk factors for CTS.
LEVEL OF EVIDENCE
I, Prognosis.
REGISTRATION
INPLASY (202280018).
Topics: Humans; Female; Carpal Tunnel Syndrome; Databases, Factual; Hormone Replacement Therapy; Research Design; Risk Factors
PubMed: 37308714
DOI: 10.1186/s10195-023-00707-5 -
CMAJ : Canadian Medical Association... Sep 2011Peripheral nerve palsies of the upper extremities presenting at birth can be distressing for families and care providers. It is therefore important to be able to... (Review)
Review
BACKGROUND
Peripheral nerve palsies of the upper extremities presenting at birth can be distressing for families and care providers. It is therefore important to be able to identify patients whose diagnosis is compatible with full recovery so that their families can be reassured.
METHODS
We conducted a retrospective review of all infants presenting with weakness of the upper extremity to our clinic between July 1995 and September 2009. We also conducted a review of the current literature.
RESULTS
During the study period, 953 infants presented to our clinic. Of these patients, 25 were identified as having isolated radial nerve palsy (i.e., a radial nerve palsy in isolation with good shoulder function and intact flexion of the elbow). Seventeen infants (68.0%) had a subcutaneous nodule representing fat necrosis in the inferior posterolateral portion of the affected arm. Full recovery occurred in all patients within a range of one week to six months, and 72.0% of the patients (18/25) had fully recovered by the time they were two months old.
INTERPRETATION
Although the outcome of obstetrical brachial plexus palsy is highly variable, isolated radial nerve palsy in the newborn carries a uniformly favourable prognosis.
Topics: Female; Humans; Infant, Newborn; Male; Prognosis; Radial Neuropathy; Retrospective Studies
PubMed: 21768251
DOI: 10.1503/cmaj.110272 -
Revista Chilena de Pediatria Feb 2020Sciatic neuropathy is rare and difficult to diagnose in pediatrics, and its long-term course has not been completely understood.
INTRODUCTION
Sciatic neuropathy is rare and difficult to diagnose in pediatrics, and its long-term course has not been completely understood.
OBJECTIVE
To analyze the clinical presentation and evolution of a group of pediatric patients with sciatic neuropathy.
PATIENTS AND METHOD
Retrospective anal ysis of the clinical characteristics of pediatric patients with sciatic neuropathy treated in two hospitals of Santiago between 2014 and 2018. Locomotor examination, muscle trophism, deep tendon reflexes, gait, sensation, and pain were assessed. Sciatic nerve conduction study and electromyography (EMG) were performed, and magnetic resonance imaging (MRI) in three patients.
RESULTS
Six patients were included with an average age of 11.8 years. The etiologies were traumatic (N = 2), by compression (N = 2), vascular (N = 1), and tumor (N = 1). All of the 6 patients presented foot drop and Achilles tendon hyporeflexia/areflexia, and 5 patients presented severe neuropathic pain. The EMG showed involvement of the sciatic nerve rami and dependent muscles. In two patients, a pelvic girdle and lower limbs MRI was performed, showing selective muscle involvement in sciatic territory. One patient underwent a lumbosacral plexus MRI, and subsequently histological study showing a benign neural tumor. Out of the three patients who were followed-up longer than one year presented motor sequelae and gait disorder.
CONCLUSION
Sciatic neuropathy in the study group was secondary to different causes, predominantly traumatic and compressive etiologies. The three patients that were ina long-term follow-up presented significant motor sequelae. In most of the cases, neural injury wasassoci- ated with preventable causes, such as accidents and positioning in unconscious children, which is crucial in the prevention of a pathology with a high sequelae degree.
Topics: Adolescent; Child; Child, Preschool; Electromyography; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Prognosis; Retrospective Studies; Risk Factors; Sciatic Neuropathy
PubMed: 32730417
DOI: 10.32641/rchped.v91i1.1355 -
European Journal of Heart Failure Mar 2020
Topics: Amyloidosis; Carpal Tunnel Syndrome; Early Diagnosis; Heart Failure; Humans; Prognosis
PubMed: 32069519
DOI: 10.1002/ejhf.1763 -
Journal of Neurology, Neurosurgery, and... Apr 1992
Topics: Carpal Tunnel Syndrome; Humans; Median Nerve; Synaptic Transmission; Thyrotoxicosis
PubMed: 1316432
DOI: 10.1136/jnnp.55.4.332 -
Plastic and Reconstructive Surgery Sep 2009After reading this article (part II of II), the participant should be able to: 1. Describe the anatomy and function of the median and ulnar nerves in the forearm and... (Review)
Review
LEARNING OBJECTIVES
After reading this article (part II of II), the participant should be able to: 1. Describe the anatomy and function of the median and ulnar nerves in the forearm and hand. 2. Describe the clinical deficits associated with injury to each nerve. 3. Describe the indications, benefits, and drawbacks for various tendon transfer procedures used to treat median and ulnar nerve palsy. 4. Describe the treatment of combined nerve injuries. 5. Describe postoperative care and possible complications associated with these tendon transfer procedures.
SUMMARY
This article discusses the use of tendon transfer procedures for treatment of median and ulnar nerve palsy and combined nerve palsies. Postoperative management and potential complications are also discussed.
Topics: Humans; Median Neuropathy; Postoperative Care; Tendon Transfer; Ulnar Neuropathies
PubMed: 19730287
DOI: 10.1097/PRS.0b013e3181b037c7 -
The Cochrane Database of Systematic... Oct 2008Carpal tunnel syndrome results from entrapment of the median nerve in the wrist. Common symptoms are tingling, numbness, and pain in the hand that may radiate to the... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Carpal tunnel syndrome results from entrapment of the median nerve in the wrist. Common symptoms are tingling, numbness, and pain in the hand that may radiate to the forearm or shoulder. Most symptomatic cases are treated non-surgically.
OBJECTIVES
The objective is to compare the efficacy of surgical treatment of carpal tunnel syndrome with non-surgical treatment.
SEARCH STRATEGY
We searched the Cochrane Neuromuscular Disease Group Trials Register (January 2008), MEDLINE (January 1966 to January 2008), EMBASE (January 1980 to January 2008) and LILACS (January 1982 to January 2008). We checked bibliographies in papers and contacted authors for information about other published or unpublished studies.
SELECTION CRITERIA
We included all randomised and quasi-randomised controlled trials comparing any surgical and any non-surgical therapies.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed the eligibility of the trials.
MAIN RESULTS
In this update we found four randomised controlled trials involving 317 participants in total. Three of them including 295 participants, 148 allocated to surgery and 147 to non-surgical treatment reported information on our primary outcome (improvement at three months of follow-up). The pooled estimate favoured surgery (RR 1.23, 95% CI 1.04 to 1.46). Two trials including 245 participants described outcome at six month follow-up, also favouring surgery (RR 1.19, 95% CI 1.02 to 1.39).Two trials reported clinical improvement at one year follow-up. They included 198 patients favouring surgery (RR 1.27, 95% CI 1.05 to 1.53). The only trial describing changes in neurophysiological parameters in both groups also favoured surgery (RR 1.44, 95% CI 1.05 to 1.97). Two trials described need for surgery during follow-up, including 198 patients. The pooled estimate for this outcome indicates that a significant proportion of people treated medically will require surgery while the risk of re-operation in surgically treated people is low (RR 0.04 favouring surgery, 95% CI 0.01 to 0.17). Complications of surgery and medical treatment were described by two trials with 226 participants. Although the incidence of complications was high in both groups, they were significantly more common in the surgical arm (RR 1.38, 95% CI 1.08 to 1.76).
AUTHORS' CONCLUSIONS
Surgical treatment of carpal tunnel syndrome relieves symptoms significantly better than splinting. Further research is needed to discover whether this conclusion applies to people with mild symptoms and whether surgical treatment is better than steroid injection.
Topics: Adrenal Cortex Hormones; Carpal Tunnel Syndrome; Humans; Randomized Controlled Trials as Topic; Splints
PubMed: 18843618
DOI: 10.1002/14651858.CD001552.pub2 -
Journal of Neurovirology Dec 2021The involvement of the nervous system may occur in 36.4% of patients with COVID-19. Cases have been described of cerebrovascular diseases, encephalitis,...
The involvement of the nervous system may occur in 36.4% of patients with COVID-19. Cases have been described of cerebrovascular diseases, encephalitis, encephalopathies, and changes in smell and taste. Two months after being discharged from hospital with COVID-19, a 63-year-old male patient presented with a predominantly demyelinating multiple sensory and motor mononeuropathy. A diagnostic possibility of multiple sensory and motor demyelinating mononeuropathy (Lewis-Sumner syndrome) was made. Treatment with human immunoglobulin was initiated. COVID-19 may be associated with multiple demyelinating sensory and motor mononeuropathy.
Topics: Brain Diseases; COVID-19; Cerebrovascular Disorders; Humans; Male; Middle Aged; Mononeuropathies
PubMed: 34735692
DOI: 10.1007/s13365-021-01024-5