• The Korean Journal of Pain
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• 제6권1호
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• pp.117-121
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• 1993

The pyriformis syndrome is an entrapment neuropathy in which the sciatic nerve is compromised by the pyriformis muscle. Using local anesthetics and steroid injection through a needle guided by an electric nerve stimulator, we satisfactorily treated a case of pyriformis syndrome.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.95-98
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• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

• Journal of Korean Neurosurgical Society
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• 제61권4호
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• pp.509-515
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• 2018

Objective : In Asians, kneeling and squatting are the postures that are most often induce common peroneal neuropathy. However, we could not identify a compatible compression site of the common peroneal nerve (CPN) during hyper-flexion of knees. To evaluate the course of the CPN at the popliteal area related with compressive neuropathy using magnetic resonance imaging (MRI) scans of healthy Koreans. Methods : 1.5-Tesla knee MRI scans were obtained from enrolled patients and were retrospectively reviewed. The normal populations were divided into two groups according to the anatomical course of the CPN. Type I included subjects with the CPN situated superficial to the lateral gastocnemius muscle (LGCM). Type II included subjects with the CPN between the short head of biceps femoris muscle (SHBFM) and the LGCM. We calculated the thickness of the SHBFM and posterior elongation of this muscle, and the LGCM at the level of femoral condyles. In type II, the length of popliteal tunnel where the CPN passes was measured. Results : The 93 normal subjects were included in this study. The CPN passed through the "popliteal tunnel" formed between the SHBFM and the LGCM in 36 subjects (38.7% type II). The thicknesses of SHBFM and posterior portions of this muscle were statistically significantly increased in type II subjects. The LGCM thickness was comparable in both groups. In 78.8% of the "popliteal tunnel", a length of 21 mm to <40 mm was measured. Conclusion : In Korean population, the course of the CPN through the "popliteal tunnel" was about 40%, which is higher than the Western results. This anatomical characteristic may be helpful for understanding the mechanism of the CPNe by posture.

• The Korean Journal of Pain
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• 제13권1호
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• pp.123-125
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• 2000

Rectus abdominis syndrome is the abdominal pain which occurs in the distribution of the medial or lateral cutaneous branch of the 7~12th intercostal nerves. It is frequently cause that results in unnecessary pain and expense to patient. The physical examination is difficult because of severe abdominal pain. We must have attention to the possibility that patients with abdominal pain, in whom no intra- abdominal cause is founded, may suffer from this presumed nerve entrapment syndrome. If we can find the cause of pain in the abdominal rectus muscle, no evaluation and surgery are required and therapy can be simple.

• Archives of Hand and Microsurgery
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• 제23권4호
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• pp.267-270
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• 2018

운동 반회 신경 가지의 포착 증후군은 정중신경 운동 반회 가지(recurrent motor branch of median nerve)의 해부학적 변이에서 발생하는 압박에 의한 신경병증(compressive neuropathy)이다. 빈도는 매우 드물지만 이러한 해부학적 변형이 원인이 된 경우 횡수근 인대 유리술(transcarpal ligament release)만을 시행한다면 무지구군의 위축과 위약은 잔존하게 될 가능성이 높다. 저자들은 젊은 요리사에서 칼자루에 무지구근 주위가 반복적으로 자극된 이후 발생한 수근관 증후군에 동반된 운동 반회 신경 가지의 포착 증후군을 진단하고 운동 반회 신경 분지의 감압술(decompreesion) 및 신경박리술(neurolysis)을 시행한 1예를 경험하여 문헌고찰과 함께 보고하고자 한다.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.117-120
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• 2011

Purpose: Carpal tunnel syndrome is the most common peripheral compressive neuropathy. Most cases are idiopathic, but rarely carpal tunnel syndrome can be associated with a ganglionic mass. We report our recently encountered experience of surgical treatment of carpal tunnel syndrome caused by a simple ganglionic mass. Methods: A 53-year-old man presented with chief complaints of numbness and hypoesthesia of his left palm, thumb, index finger, long finger, and ring finger of one and half month duration. Physical examination revealed positive Tinnel's sign without previous trauma, infection or any other events. Electromyography showed entrapment neuropathy of the median nerve. Magnetic resonance imaging (MRI) showed an approximately 2.0 cm-sized mass below the transverse carpal ligament. Upon surgical excision, a $1{\times}1.5cm^2$ mass attached to the perineurium of the median nerve and synovial sheath of the flexor digitorum superficialis and redness and hypertrophy of the median nerve were discovered. With surgical intervention, we completely removed the ganglionic mass and performed surgical release of the transverse carpal ligament. Results: The pathology report confirmed the mass to be a ganglion. The patient exhibited post-operative improvement of his symptoms and did not show any complications. Conclusion: We present a review of our experience with this rare case of carpal tunnel syndrome caused by a ganglionic mass and give a detailed follow-up on the patient treated by surgical exploration with carpal tunnel release.

• Annals of Clinical Neurophysiology
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• 제9권1호
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• pp.33-35
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• 2007

Meralgia paresthetica (MP) is a benign entrapment neuropathy which is characterized by sensory impairment and paresthesia in the cutaneous distribution of the lateral femoral cutaneous nerve. A 79-year-old woman presented with intermittent right inguinal burning sensation. The sensory nerve conduction study (NCS) showed decreased right side sensory nerve action potential (SNAP) on lateral femoral cutaneous nerve compared to the contralateral one. Abdomino-pelvic CT showed bilateral huge renal cysts (The size of largest one on right side: about $6.2{\times}5.0cm$). We report a case of MP caused by a huge abdominal renal cyst, which should be considered when conventional examination reveals no responsible etiology.

• 대한정형외과 초음파학회지
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• 제1권2호
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• pp.128-133
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• 2008

신경 압박의 원인은 외부로부터 가해지는 것도 있고, 신체 내부 병리가 발생하여 신경 주행에 따라 발생할 수 있다. 주관절 이하부에서 압박성 신경병증으로 정중 신경, 척골 신경, 요골신경병증이 있다. 정중 신경은 굴곡 지대부위에서 수근관 증후군이 대표적이며, 모든 신경 포착 증후군 가운데 가장 흔하다. 그 외 주관절 부위에서 스트러더스 인대, 상완 이두근 건막, 회내근, 천수지 굴근 기시부 그리고 비정상 근육들에 의한 회내근 증후군과 전 골간 신경 증후군이 있다. 척골 신경은 스트러더스 궁, 내측 상과 후방의 주관, 척수근 굴근 두 기시부 사이의 건막 등에서 눌리는 주관 증후군과, 수근부에서 결절종, 유구골 갈고리 골절 그리고 혈관성으로 오는 척골 관 증후군이 있다. 요골 신경의 심부 분지가 회외근속을 지나면서 만들어지는 부위에서 눌리는 경우 요골 관 증후군이라고 한다. 치료는 초기에는 소염제나 야간부목, 스테로이드 주사와 같은 보존적 치료를 시행할 수 있으며, 이에 호전되지 않을 경우 전기적 검사나 영상 검사에서 이상이 나타나면 수술적 감압술을 시행하여야 한다.

• 대한족부족관절학회지
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• 제15권2호
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• pp.58-61
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• 2011

전족부 통증의 주요 원인 중의 하나인 모턴씨 신경종, 즉 족지간 신경염은 진정한 종양이 아니라 신경 포착 증후군의 일종으로 이해되고 있으며, 진단 시 정확한 이학적 검사와 함께 전족부 통증의 원인이 되는 다른 질환과도 감별해야 한다. 치료에 있어서는 적절한 보존적 치료에도 증상 호전이 되지 않는 환자에게 수술적 치료로서 신경절제술이 주로 시행되어 약 80%의 환자가 만족하는 좋은 결과를 보고하고 있으나, 수술 후 만족스럽지 않은 결과를 보이는 2~35%의 환자를 적절히 처치함으로써 족지간 신경염의 치료 결과를 좀 더 만족스럽게 할 수 있을 것이다.

• 대한족부족관절학회지
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• 제20권2호
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• pp.84-87
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• 2016

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or its branches in the fibro-osseous tunnel beneath the flexor retinaculum. This pathology is associated with multiple etiologies, including trauma, space-occupying lesions, and impaired biomechanics. We report a case of tarsal tunnel syndrome associated with gout tophi in a patient with untreated gout along with a review of the relevant literature on tarsal tunnel syndrome.