• Title/Summary/Keyword: Entrapment neuropathy

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Entrapment Neuropathy of Median and Ulnar Nerve Due to Soft Tissue Chondroma: A Case Report (연부조직 연골종에 의한 정중, 척골포착신경병증: 증례보고)

  • Hong, Sung-Taek;Ahn, Duck-Sun
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.815-818
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    • 2010
  • Purpose: Soft tissue chondroma is a rare benign tumor, found mainly on the palm and sole and grows slowly. Typically, mature hyaline cartilage is the dominant pathological feature. There are reports that assert soft tissue chondromas to be a cause of median nerve entrapment syndrome. However, this is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy. Methods: A 62 year-old woman presented with chief complaints of numbness and hypoesthesia of her right palm for 4 to 5 years, and a palpable mass on her right palm that had been increasing in size slowly for 3 years. Physical examination revealed a firm, mobile, non-tender and about $3{\times}3\;cm^2$ sized mass in the center of the right palm. Electromyography showed entrapment neuropathy of the median and ulnar nerve. Ultrasonography showed an approximately $5.7\;cm^2$ mass below the flexor tendon of ring finger. Upon surgical excision, a $3{\times}3\;cm^2$ mass attached to the flexor digitorum profundus of ring finger and redness and hypertrophy of both the median and ulnar nerve were discovered. Mass excision was performed gently and the specimen was referred for histopathologic study. Mass excision resulted in median and ulnar nerve release. Results: The pathology report confirmed the mass to be a soft tissue chondroma with mature hyaline cartilage. The patient exhibited post-operative improvement of her symptoms and did not show any complications. Conclusion: This is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy.

Decompression of the Sciatic Nerve Entrapment Caused by Post-Inflammatory Scarring

  • Son, Byung-Chul;Kim, Deog-Ryeong;Jeun, Sin Soo;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.57 no.2
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    • pp.123-126
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    • 2015
  • A rare case of chronic pain of entrapment neuropathy of the sciatic nerve successfully relieved by surgical decompression is presented. A 71-year-old male suffered a chronic right buttock pain of duration of 7 years which radiating to the right distal leg and foot. His pain developed gradually over one year after underwenting drainage for the gluteal abscess seven years ago. A cramping buttock and intermittently radiating pain to his right foot on sitting, walking, and voiding did not respond to conventional treatment. An MRI suggested a post-inflammatory adhesion encroaching the proximal course of the sciatic nerve beneath the piriformis as it emerges from the sciatic notch. Upon exploration of the sciatic nerve, a fibrotic tendinous scar beneath the piriformis was found and released proximally to the sciatic notch. His chronic intractable pain was completely relieved within days after the decompression. However, thigh weakness and hypesthesia of the foot did not improve. This case suggest a need for of more prompt investigation and decompression of the chronic sciatic entrapment neuropathy which does not improve clinically or electrically over several months.

Lumbar foraminal neuropathy: an update on non-surgical management

  • Choi, Young Kook
    • The Korean Journal of Pain
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    • v.32 no.3
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    • pp.147-159
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    • 2019
  • Lumbar foraminal pathology causing entrapment of neurovascular contents and radicular symptoms are commonly associated with foraminal stenosis. Foraminal neuropathy can also be derived from inflammation of the neighboring lateral recess or extraforaminal spaces. Conservative and interventional therapies have been used for the treatment of foraminal inflammation, fibrotic adhesion, and pain. This update reviews the anatomy, pathophysiology, clinical presentation, diagnosis, and current treatment options of foraminal neuropathy.

Pharmacoacupuncture Treatment of Coccygodynia Caused by Perforating Cutaneous Nerve Entrapment Syndrome: Two Cases Report (관통피부신경 포착으로 발생한 꼬리뼈 통증 환자 약침치료 치험 2예)

  • Moon, Sori;An, Sunjoo;Choi, Seonghwan;Park, Seohyun;Keum, Dongho
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.149-156
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    • 2019
  • This study was performed to evaluate the effectiveness of pharmacoacupuncture treatment of coccygodynia caused by perforating cutaneous nerve entrapment syndrome. Two patients were diagnosed as coccygodynia caused by perforating cutaneous nerve entrapment syndrome which pain was within the anatomical field of the nerve, worsened by pressure-inducing posture, no objective sensory loss and in presence of pin-point tenderness. They were treated by pharmacoacupuncture at perforating cutaneous nerve region penertrating the sacrotuberous ligament and local tenderness point of coccyx. The evaluation of clinical outcome was done by pain intensity numerical rating scale (PI-NRS), pressure pain threshold (PPT) and EuroQol five dimensions questionnaire (EQ-5D) index. After treatment, their PI-NRS was decreased, PPT and EQ-5D index were increased. The pharmacoacupuncture therapy at entrapment point of perforating cutaneous nerve could be an effective way to treat coccygodynia caused by perforating cutaneous nerve entrapment syndrome.

Usefulness of Ultrasound for Detecting Suspected Peripheral Nerve Lesions in Diagnosis of Peripheral Neuropathy : Case Report and Brief Review of the Literature

  • Jung, Jae-Hyun;Kim, Kwang-Hai;Choi, Soon-Kyoo;Shim, Jae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.132-135
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    • 2013
  • Ultrasound scanning of a peripheral nerve along its expected course is a simple and useful method for determining the cause of peripheral neuropathy. We present 3 cases of peripheral neuropathy in which the pathology was detected by simple ultrasound scanning of the affected nerve. There were 2 cases of entrapment neuropathy due to mucoid cyst and 1 case of nerve sheath tumor. All lesions were visualized by simple ultrasound scanning of the involved peripheral nerve. Our results suggest that if a lesion affecting the peripheral nerve is suspected after history and physical examination or electrophysiologic studies, ultrasound scanning of the peripheral nerve of interest throughout its course is very helpful for identifying the causative lesion.

Ultrasound Guided Transversus Abdominis Plane Block for Anterior Cutaneous Nerve Entrapment Syndrome

  • Sahoo, Rajendra Kumar;Nair, Abhijit S.
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.284-286
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    • 2015
  • Anterior cutaneous nerve entrapment syndrome (ACNES) is one the most common cause of chronic abdominal wall pain. The syndrome is mostly misdiagnosed, treated wrongly and inadequately. If diagnosed correctly by history, examination and a positive carnett test, the suffering of the patient can be relieved by addressing the cause i.e. local anaesthetic with steroid injection at the entrapment site. Conventionally, the injection is done by landmark technique. In this report, we have described 2 patients who were diagnosed with ACNES who were offered ultrasound guided transverses abdominis plane (TAP) injection who got significant pain relief for a long duration of time.

Superficial Peroneal Nerve Entrapment Syndrome (A Case Report) (표재비골신경 포착증후군(1예 보고))

  • Chae, Soo-Uk;Kim, Yeung-Jin;Choi, Byong-San;Song, Ha-Heon
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.62-64
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    • 2012
  • Superficial peroneal nerve entrapment is an uncommon compression neuropathy, and is frequently associated with a fascial defect and a muscle hernia. The standard treatment of that was the nerve decompression by complete or limited fasciotomy. But, we experienced a case of superficial peroneal nerve entrapment had satisfactory surgical outcome by fascial repair of peroneus muscle.

Clinical Features of Wrist Drop Caused by Compressive Radial Neuropathy and Its Anatomical Considerations

  • Han, Bo Ram;Cho, Yong Jun;Yang, Jin Seo;Kang, Suk Hyung;Choi, Hyuk Jai
    • Journal of Korean Neurosurgical Society
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    • v.55 no.3
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    • pp.148-151
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    • 2014
  • Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.

Tarsal Tunnel Syndrome associated with Os Sustentaculi (A Case Report) (지주골에 의한 족근관 증후군 (1예 보고))

  • Park, Ju Yong;Kim, Bom Soo
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.1
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    • pp.74-77
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    • 2013
  • Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel, and is often caused by ganglia, lipoma, accessory muscles, varicosities, neural tumours, trauma and systemic diseases. We have successfully treated a patient with tarsal tunnel syndrome which was associated with os sustentaculi.

Lipoma of the Tendon Sheath that Caused Peripheral Neuropathy (말초 신경병증을 초래한 건초주위 지방종)

  • Kim, Sehee;Lee, Yong-Suk;Kim, Jae Min
    • Clinical Pain
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    • v.20 no.1
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    • pp.20-24
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    • 2021
  • In this case report, we present a rare case of lipoma of the tendon sheath localized to the wrist which caused median entrapment neuropathy and was successfully treated with surgical excision. Dynamic examination using ultrasonography revealed the exact location of the lipoma. Electrodiagnostic study (EDX) was done before surgery to elucidate combined neuropathy, and surgery for ulnar neuropathy around elbow was also performed simultaneously. Diagnostic ultrasound can be used for dynamic examinations with real-time visualization.