• Title/Summary/Keyword: Median Nerve

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A Case of Strong Palm Compression-Induced Thenar Motor Neuropathy (강한 손바닥 압박 후 속발된 엄지두덩운동신경병증 1예)

  • Lee, Jeong-Gon;Jang, Il-Mi;Lee, Kyung-Bok;Roh, Hakjae;Ahn, Moo-Young
    • Annals of Clinical Neurophysiology
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    • v.14 no.1
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    • pp.41-44
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    • 2012
  • Thenar motor neuropathy (TMN) is a compressive mononeuropathy of recurrent motor branch of median nerve. It is infrequent and may have different pathogenesis. It may be a unique entity of disease or considered a variant of carpal tunnel syndrome involving the motor branch only. We report a case of TMN induced by vigorous massage that applied strong digital pressure in the region of the base of palm and thenar muscles.

Early Surgical Treatment of Pronator Teres Syndrome

  • Lee, Ho Jin;Kim, Ilsup;Hong, Jae Taek;Kim, Moon Suk
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.296-299
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    • 2014
  • We report a rare case of pronator teres syndrome in a young female patient. She reported that her right hand grip had weakened and development of tingling sensation in the first-third fingers two months previous. Thenar muscle atrophy was prominent, and hypoesthesia was also examined on median nerve territory. The pronation test and Tinel sign on the proximal forearm were positive. Severe pinch grip power weakness and production of a weak "OK" sign were also noted. Routine electromyography and nerve conduction velocity showed incomplete median neuropathy above the elbow level with severe axonal loss. Surgical treatment was performed because spontaneous recovery was not seen one month later.

A Case of the Solitary Neurofibroma at the Median Nerve -Ultrastructural Study- (정중신경에 발생한 신경섬유종 치험례 -초미형태학적 관찰-)

  • Ihn, Joo-Chul;Ahn, Jong-Chul;Kim, Sae-Dong;Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.199-206
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    • 1984
  • With respect to the histogenesis of the neurofibroma, there are many controversies, since von Recklinghausen postulated that neurofibromas are mainly fibrous tumors arising from the connective tissue of the nerve sheaths. According to the recent studies through the electron microscope, the neoplastic perineurial cells are regarded as the main components of the tumor. So, the neurofibroma enucleated from the median nerve at the level of proximal arm without resulting neurologic sequale was examined through the light- and electron microscope. Ultrastructurally, this tumor is composed of the perineurial cells, fibroblasts, and collagen fibers. The predominant perineurial cells show distinct basal lamina, and contain abundant microfilaments.

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Anatomy of Large Intestine Meridian Muscle in human (수양명경근(手陽明經筋)의 해부학적(解剖學的) 고찰(考察))

  • Sim Young;Park Kyoung-Sik;Lee Joon-Moo
    • Korean Journal of Acupuncture
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    • v.19 no.1
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    • pp.15-23
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    • 2002
  • This study was carried to identify the component of Large Intestine Meridian Muscle in human, dividing into outer, middle, and inner part. Brachium and antebrachium were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Large Intestine Meridian Muscle. We obtained the results as follows; 1. Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows. 1) Muscle; extensor digitorum tendon(LI-1), lumbrical tendon(LI-2), 1st dosal interosseous muscle(LI-3), 1st dosal interosseous muscle and adductor pollicis muscle(LI-4), extensor pollicis longus tendon and extensor pollicis brevis tendon(LI-5), adductor pollicis longus muscle and extensor carpi radialis brevis tendon(LI-6), extensor digitorum muscle and extensor carpi radialis brevis mucsle and abductor pollicis longus muscle(LI-7), extensor carpi radialis brevis muscle and pronator teres muscle(LI-8), extensor carpi radialis brevis muscle and supinator muscle(LI-9), extensor carpi radialis longus muscle and extensor carpi radialis brevis muscle and supinator muscle(LI-10), brachioradialis muscle(LI-11), triceps brachii muscle and brachioradialis muscle(LI-12), brachioradialis muscle and brachialis muscle(LI-13), deltoid muscle(LI-14, LI-15), trapezius muscle and supraspinous muscle(LI-16), platysma muscle and sternocleidomastoid muscle and scalenous muscle(LI-17, LI-18), orbicularis oris superior muscle(LI-19, LI-20) 2) Nerve; superficial branch of radial nerve and branch of median nerve(LI-1, LI-2, LI-3), superficial branch of radial nerve and branch of median nerve and branch of ulna nerve(LI-4), superficial branch of radial nerve(LI-5), branch of radial nerve(LI-6), posterior antebrachial cutaneous nerve and branch of radial nerve(LI-7), posterior antebrachial cutaneous nerve(LI-8), posterior antebrachial cutaneous nerve and radial nerve(LI-9, LI-12), lateral antebrachial cutaneous nerve and deep branch of radial nerve(LI-10), radial nerve(LI-11), lateral antebrachial cutaneous nerve and branch of radial nerve(LI-13), superior lateral cutaneous nerve and axillary nerve(LI-14), 1st thoracic nerve and suprascapular nerve and axillary nerve(LI-15), dosal rami of C4 and 1st thoracic nerve and suprascapular nerve(LI-16), transverse cervical nerve and supraclavicular nerve and phrenic nerve(LI-17), transverse cervical nerve and 2nd, 3rd cervical nerve and accessory nerve(LI-18), infraorbital nerve(LI-19), facial nerve and infraorbital nerve(LI-20). 3) Blood vessels; proper palmar digital artery(LI-1, LI-2), dorsal metacarpal artery and common palmar digital artery(LI-3), dorsal metacarpal artery and common palmar digital artery and branch of deep palmar aterial arch(LI-4), radial artery(LI-5), branch of posterior interosseous artery(LI-6, LI-7), radial recurrent artery(LI-11), cephalic vein and radial collateral artery(LI-13), cephalic vein and posterior circumflex humeral artery(LI-14), thoracoacromial artery and suprascapular artery and posterior circumflex humeral artery and anterior circumflex humeral artery(LI-15), transverse cervical artery and suprascapular artery(LI-16), transverse cervical artery(LI-17), SCM branch of external carotid artery(LI-18), facial artery(LI-19, LI-20)

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Recurrent Pleomorphic Adenomas of the Parotid Gland (재발성 이하선 다형성 선종)

  • Huh H.;Chung Woung-Yoon;Yoon Jong-Ho;Chang Hang-Seok;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.3-8
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    • 2003
  • Background: Surgical management of recurrent pleomorphic adenoma of the parotid gland has a considerable risk of facial nerve injury and a high re-recurrence rate. To obtain more insight into the issue of recurrent pleomorphic adenoma and more specifically to evaluate our experience and results of treatment, a retrospective study was carried out. Materials and Methods: During the period from 1989 to 2002, the medical records of 14 patients who underwent a operation for recurrent pleomorphic adenoma of the parotid gland were reviewed retrospectively. The initial operation for parotid tumor, clinical features of recurrence, reoperation after recurrence, po stop complication were analysed. Results: The male to female ratio was 6 : 9. Median age of the patients at the time of the initial operation was 33 years and at the time of the reoperation was 43 years. The median interval until recurrence was 105 months (6-252 months). The initial operations performed were excision or enucleation in 10 patients, superficial parotidectomy in 3 patients, total parotidectmy in 1 patients. The thirteen patients were underwent reoperation (8 superficial parotidectomies, 3 total parotidectomies, 1 neartotal parotidectomy, 1 wide excision). The facial nerve paralysis after the reoperation occured in 6 patients but all of them were recovered from 3 months to 1 year after surgery. Conclusion: In the management of pleomorphic adenoma of the parotid gland, excision or enucleation is to be avoided due to the higher recurrence rate and superficial or total parotidectomy with preservation of the facial nerve are to be preferred. Because the risk of facial nerve injury during operation for the recurrent tumor was higher than initial surgery, more careful surgical procedure is mandatory for preserving the facial nerve.

Electromyographic and Clinical Investigation of the Effect of Platelet-Rich Plasma on Peripheral Nerve Regeneration in Patients with Diabetes after Surgery for Carpal Tunnel Syndrome

  • Yasak, Tugce;Ozkaya, Ozay;Sahin, Ayca Ergan;Colak, Ozlem
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.200-206
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    • 2022
  • Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Studies have shown that results of CTS surgery are poorer in patients with diabetes. In this study, the effect of platelet-rich plasma (PRP) on nerve regeneration was investigated through clinical and electromyographic findings in patients with diabetes who underwent CTS surgery. Methods A retrospective analysis of 20 patients with diabetes who had surgically decompressed CTS was conducted. Patients were divided into two groups. The study group received PRP treatment following surgery. The control group did not receive any treatment. Patients were assessed using electromyography and the Boston Carpal Tunnel Syndrome Questionnaire preoperatively as well as postoperatively at 3-month, 6-month, and 1-year follow-ups visits. Results There was a decrease in complaints and an improvement in sensory and motor examinations in both groups. The Boston Carpal Tunnel Syndrome Questionnaire scores did not show any statistically significant differences between the two groups. However, electromyographic findings showed that there were statistical differences between preoperative and postoperative (3 months, 6 months, and 1 year) results in both groups. When the two groups were compared using preoperative and postoperative (3 months, 6 months, and 1 year) electromyographic values, no statistically significant differences were seen. Conclusion Single injections of PRP did not have a significant impact on median nerve regeneration following CTS surgery in patients with diabetes. The effectiveness of multiple PRP injections can be investigated in patients with diabetes in future studies.

Clinical and Electrophysiological Features of HNPP Patients with 17p11.2 Deletion (염색체 17p11.2 유전자 결손을 동반한 유전성 압박마비 편향 신경병증의 임상적, 전기생리학적 특성)

  • Hong, Yoon-Ho;Kim, Manho;Sung, Jung-Joon;Kim, Sung Hun;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.125-132
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    • 2002
  • Objectives : Although the diagnosis of hereditary neuropathy with liability to pressure palsies (HNPP) is important for correct prognostic evaluation and genetic counseling, the diagnosis is frequently missed or delayed. Our main aim on undertaking this study was to characterize the electrodiagnostic features of HNPP. Material and Methods : Clinical, electrophysiologic and molecular studies were performed on Korean HNPP patients with 17p11.2 deletion. The results of electrophysiologic studies were compared with those of Charcot-Marie-Tooth disease type 1A (CMT1A) patients carrying 17p11.2 duplication. Results : Eight HNPP (50 motor, 39 sensory nerves) and six CMT1A (28 motor, 16 sensory nerves) patients were included. The slowing of sensory conduction in nearly all nerves and the distal accentuation of motor conduction abnormalities are the main features of background polyneuropathy in HNPP. In contrast to CMT1A, where severity of nerve conduction slowing was not different among nerve groups, HNPP sensory nerve conduction was more slowed in the median and ulnar nerves than in the sural nerve (p<0.01), and DML was more prolonged in the median nerve than in the other motor nerves (p<0.01). TLIs were significantly lower in HNPP than in the normal control and CMT1A patients for the median and ulnar nerves (p<0.01), and were also significantly reduced for the peroneal nerve (p<0.05) compared with those of the normal controls. Conclusion : The distribution and severity of the background electrophysiologic abnormalities are closely related to the topography of common entrapment or compression sites, which suggests the possible pathogenetic role of subclinical pressure injury at these sites in the development of the distinct background polyneuropathy in HNPP.

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Nerve Conduction Velocity among Farmers Exposed to Pesticides (일부 농약 폭로 농민들의 신경전도 검사에 관한 연구)

  • Lee, Won-Jin;Choi, Jin-Yong;Lee, Kun-Sei
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.1-11
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    • 1999
  • This study was carried out to find out if peripheral neuropathy was resulting from exposed to pesticides in farmers. Thirty four male farmers in rural area of Chungju were selected as a study group. According to the farm type and area, the group was subdivided into two groups: the high exposed group(n=20) and the low exposed group(n=14). Nerve conduction velocity tests were done on four nerves of the dominant arm(median motor, median sensory, ulnar sensory, and ulnar motor) and three nerves of the dominant leg(peroneal motor, sural sensory, and posterior tibial motor). On the nerve conduction study, all of the results were included normal range. But comparing to reference mean values, most of results were significantly decreased(P < 0.01 by t-test). And the median motor conduction velocity and the peroneal nerve latency were significantly increased in the high exposed group than the low exposed group and reference values. But we concluded that these findings are caused by age difference not pesticide exposure. In conclusion, we cannot find any abnormality of nerve conduction velocity caused by exposure to pesticide in this study group.

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Diabetes affects Peripheral Nerve and Heart Function

  • Ku, Jeong-Min;Choi, Hwa-Sik;Hyun, Kyung-Yae;Moon, Seong-Min;Kim, Dae-Sik;Choi, Seok-Cheol
    • Biomedical Science Letters
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    • v.17 no.4
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    • pp.313-319
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    • 2011
  • Diabetes mellitus (DM) leads to a variety of complications and thus we have retrospectively studied to investigate problems of nerve conduction velocity (NCV) study and the heart in the patients with type-II DM. Blood glucose and blood pressure levels were higher in DM group than in Non-DM group. We found that several latencies were delayed in motor conduction study of upper (median and ulnar nerve) and lower extremities (peroneal and tibial nerve), whereas amplitudes and NCVs were decreased in DM group compared with Non-DM group. Latencies of sensory conduction study in upper and lower extremities (sural nerve) were delayed, while amplitudes and NCVs were lower in DM group than in Non-DM group. Abnormal percent of the electrocardiogram was higher in DM group than in Non-DM group. This retrospective study suggests that type-II DM can cause a damage effect on the peripheral nerve and the heart function.

Short-term Effectiveness of the Movement Direction in Neurodynamic Mobilization for Upper Limb Mobility and Pain

  • An, Hojung;Moon, Okkon;Choi, Junghyun
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.4
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    • pp.1921-1925
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    • 2019
  • Background: Neurodynamic mobilization is divided into slider mobilization and tensioner mobilization. However, movement direction in neurodynamic mobilization has been overlooked in neurodynamic exercise program. Objective: To examine the effect of movement direction in neurodynamic mobilization on upper limb mobility and pain. Design: Quasi-experimental study Methods: Twenty-two adults positive for neurodynamic test for the median nerve were recruited for participation in this study. Twenty-two subjects were allocated to the applied neurodynamic mobilization at limited side group (ANTLS, n=7), the applied neurodynamic mobilization at contralateral limited side group (ANTCLS, n=7), and the applied neurodynamic mobilization at bilateral side group (ANTBS, n=8). Before the intervention upper limb limited was measured neurodynamic test for the median nerve, pain was measured using visual analogue scale (VAS), movement direction in neurodynamic mobilization was applied to each group, and then re-measured using neurodynamic test for the median nerve and VAS. Differences the Intra-groups before and between the intergroups after intervention were analyzed. Results: In the ANTLS and ANTBS groups, a statistically significant increase in ROM and decrease in VAS score in the population before and after intervention were indicated. Statistically significant differences in VAS and ROM from before to after intervention were found among the ANTLS, ANTCLS, and ANTBS groups. Conclusions: The results of the present study indicate that movement direction in neurodynamic mobilization must be considered within the limits of its selected range of the neurodynamic exercise program.