• Title/Summary/Keyword: nerve entrapment

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A Case of Meralgia Paresthetica caused by A Huge Renal Cyst (거대 콩팥낭종에 의한 넙다리감각이상증(meralgia paresthetica) 1예)

  • Kim, Tae-Yong;Kim, Jae-Hyuk;Kim, Su-Hyun;Lim, Eun-Kwang;Lee, Yeong-Bae;Shin, Dong-Jin
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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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.

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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.

Ganglionic Cyst of the Peroneal Nerve - A Case Report - (총 비골 신경에 발생한 결절종 - 증례보고 -)

  • Song, Kwang-Son;Jeon, Si-Hyun;Kim, In-Kyu
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.212-216
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    • 2003
  • A Common peroneal nerve palsy caused by ganglionic cyst is very rare condition but well recognised entities. There have been three previous reports describing the magnetic resonance image (MRI) findings of peroneal nerve entrapment due to a ganglionic cyst. Ultrasonography, MRI, and electromyography (EMG), nerve conduction velocity (NCV), and microscopic examination were taken for diagnosis. A tubular structure near the fibular neck extending longitudinally over several slices with an inferior extension towards the superior tibiofibular joint with high T2 signal intensity was characteristic. The peroneal nerve was exposed and the ganglionic cyst was excised. The nerve was paralysed immediately after operation, but at 4 month after operation, started recovery of the function gradually and has recovered completely at 7 month. MRI is helpful to detect the extent, location, and origin of the cyst. Meticulous surgical excision can provide favorable result.

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Studies on the Knee Joint Pain (무릎관절의 통증에 관한 연구)

  • Choe, Joon-Rieb;Lee, Hee-Jeon;Choe, Wook-Yoen;Han, Sang-Yoen
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.249-257
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    • 1992
  • It is general knowledge that knee joint pain can be attributed to trauma and degenerative change around the knee joint. However most patients who have suffered from pain or limited range of motion of the knee joint show no definite pathology on X-ray or laboratory examination. We examined 242 patients with knee joint pain and found compression or entrapment of the articular nerve fiber by the tissue around the knee joint resulted in pain in almost all cases. Conclusion: by relieving the compression of the articular nerve fiber with just physical therapy and LASER stimulation on the identified trigger points, in conjunction with NSAIDs, muscle relaxants, were found to be very effective in the treatment of knee joint pain.

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Extended duration pulsed radiofrequency for the management of refractory meralgia paresthetica: a series of five cases

  • Ghai, Babita;Dhiman, Deepanshu;Loganathan, Sekar
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.215-220
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    • 2018
  • Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1-2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.

A Case of Suprascapular Neuropathy at the Spinoglenoid Notch due to a Cystic Lesion (가시관절와패임의 낭성병터로 발생한 어깨위신경병증 1예)

  • Kang, Bong-Su;Park, Kang;Choi, Jay-Chol;Kang, Sa-Yoon
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.23-25
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    • 2007
  • The symptomatology of suprascapular neuropathy is variable, depending principally on the etiology and location of the lesion. Among them, suprascapular nerve entrapment with isolated paralysis of the infraspinatus muscle is uncommon. We report a 27-year-old man presenting with right arm weakness. Based on the electrophysiologic and imaging findings, suprascapular neuropathy at the spinoglenoid notch due to cystic mass lesion was diagnosed.

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Injury in Football: Groin Injuries (축구의 특별한 손상: 서혜부 손상)

  • Young, Ki-Won;Kim, Jin-Su;Kim, Jun-Ho;Kim, Jang-Yeol;Park, Sung-Ryul;Choi, Jae-Hyuck
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.100-104
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    • 2006
  • The Incidence of groin injury was about 10% in football player These injuries occur most commonly in athletes participating in sports Involving cutting, quick accelerations and decelerations and sudden directional changes. Symptoms may range from intermittent episodes of mild discomfort to severe and chronic career-ending pain. Groin injuries may result from a variety of causes. We must keep in mind that many other conditions may also affect the groin. Because of the anatomy of the region is so complex. Ligament/muscle strains, nerve entrapment syndromes, sportsman's hernia, symphysitis, stress fractures and various hip pathologies are reviewed as causes of groin pain are reviewed as common causes of groin pain.

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Clinical and Electrophysiological Characteristics of the Patient with 'Mononeuropathy multiplex' (다발성 단신경병증의 임상적, 전기생리학적 특성)

  • Park, Kyung-Seok;Chung, Jae-Myun;Park, Seong-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.34-37
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    • 2002
  • Background : The term "mononeuropathy multiplex" means simultaneous or sequential involvement of individual noncontiguous nerve trunks, evolving over days to years. The aim of this study was to delineate the causes, clinical features, and detailed electrophysiological findings in the patients with mononeuropathy multiplex. Methods : We analyzed the medical records of 22 patients with mononeuropathy multiplex confirmed on electrophysiological studies in Inje University Seoul Paik Hospital, Seoul Municipal Boramae Hospital, and Seoul National University Hospital between 1991 to 2000. Results : The number of male and female patients was equal. The mean age was 48 years with a peak incidence in the sixth decade. The etiology could be divided into vasculitis(11 patients) or non-vasculitis group. In vasculitis group, Churg-Strauss syndrome, polyarteritis nodosa, and rheumatoid arthritis were included. The non-vasculitis group included diabetes mellitus, leprosy, and Guillain-Barre syndrome. Ulnar and median nerves were most commonly involved(91%). In descending order of frequency, peroneal, posterior tibial, sural, and radial nerves were also involved. Bilateral involvement occurred most commonly in ulnar nerve. The symptoms and signs of mononeuropathy multiplex were the initial manifestations in 12 patients(55%), which was more frequent in vasculitis group(73%). Nerve conduction abnormalities could be divided into axonal, demyelinating, or mixed type. Most(91%) of the patients in vasculitis group revealed axonal type abnormalities. The location of the nerve lesion was frequently related to potential site of entrapment in demyelinating type. Conclusions : Mononeuropathy multiplex is the presenting features of the etiological disease frequently, especially in vasculitis group. Nerve conduction studies(NCS) reveals not only axonal type but also demyelinating type abnormalities. The etiological diseases were different in each type. Therefore, NCS is very helpful for the early etiological diagnosis and therapeutic implication in the patients with mononeuropathy multiplex.

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Clinical Characteristics of Peroneal Nerve Palsy by Posture

  • Yu, Jeong Keun;Yang, Jin Seo;Kang, Suk-Hyung;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.269-273
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    • 2013
  • Objective : Posture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy. Methods : From June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time. Results : The inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients. Conclusion : We suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.

The Value of MRI in Diagnosis of Peripheral Nerve Disorders (말초신경질환에서 자기공명영상의 진단적 가치)

  • Lee, Han Young;Lee, Jang Chull;Kim, Il-Man;Lee, Chang-Young;Ikm, Eun;Kim, Dong Won;Yim, Man Bin
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1120-1126
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    • 2001
  • Objective : The development of magnetic resonance neurography(MRN) has made it possible to produce highresolution images of peripheral nerves themselves, as well as associated intraneural and extraneural lesions. We evaluated the clinical application and utility of high-resolution MRN techniques for the diagnosis and treatment of a variety of peripheral nerve disorder(PND)s. Material and Method : MRN images were obtained using T1-weighted spin echo, T2-weighted fast spin echo with fat suppression, and short tau inversion recovery(STIR) fast spin-echo pulse sequences. Fifteen patients were studied, three with brachial plexus tumors, five with chronic entrapment syndromes, and seven with traumatic peripheral lesions. Ten patients underwent surgery. Results : In MRN with STIR sequences of axial and coronal imagings, signals of the peripheral nerves with various lesions were detected as fairly bright signals and were discerned from signals of the uninvolved nerves. Increased signal with proximal swelling and distal flattening of the median nerve were seen in all patients of carpal tunnel syndrome. Among the eight patients with brachial plexus injury or tumors, T2-weighted MRN showed increased signal intensity in involved roots in five, enhanced mass lesions in three, and traumatic pseudomeningocele in three. Other associated MRI findings were adjacent bony signal change, neuroma, root adhesion and denervated muscle atophy with signal change. Conclusion : MRN with high-resolution imaging can be useful in the preoperative evaluation and surgical planning in patients with peripheral nerve lesions.

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