• Title/Summary/Keyword: peripheral nerve

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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.

Peripheral Nerve Regeneration Through Nerve Conduit Composed of Alginate-Collagen-Chitosan

  • Kim, Sang-Wan;Bae, Hong-Ki;Nam, Hye-Sung;Chung, Dong-June;Choung, Pill-Hoon
    • Macromolecular Research
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    • v.14 no.1
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    • pp.94-100
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    • 2006
  • Although the peripheral nerve system has a relatively good regenerating capacity compared to the central nerve system, peripheral nerve repair remains a clinical challenge as restoration of normal nerve function is highly variable. Synthetic tubular nerve conduits were designed as an alternative repair method in order to replace the need for an isograft. These nerve conduits guide regenerating axons from the proximal toward the distal end, maintain within growth-promoting molecules released by the nerve stumps, and protect regenerating axons from infiltrating scar tissue. In this work, we prepared cinnamoylated alginate (CA)-collagen-chitosan nerve conduit using the lyophilization method to generate a controllable parallel channel in the center and then investigated its influence on peripheral nerve regeneration in an animal study. At 12 weeks after implantation, histological study showed that tissue cable was continuously bridging the gap of the sciatic nerve in all rats. Our newly developed nerve conduit is a promising tool for use in peripheral nerve regeneration and provides a suitable experimental model for future clinical application.

Permanent Peripheral Nerve Stimulation for Chronic Occipital Neuralgia -Case reports- (만성 후두통을 영구적 후두신경자극기로 치료한 경험 -증례보고-)

  • Park, Chan Hong;Huh, Billy K
    • The Korean Journal of Pain
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    • v.21 no.2
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    • pp.155-158
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    • 2008
  • This report presents the application of occipital nerve stimulation in two patients with severe and disabling bilateral occipital neuralgia. Pain persisted despite the use of several procedures and the administration of medication in the patients. The patients underwent peripheral nerve stimulation for the treatment of headache. Peripheral nerve stimulation was accomplished via implantation of a subcutaneous electrode to stimulate the peripheral nerve in the occipital area. The patients reported a 90% improvement in overall pain. These cases illustrate the possible utilization of peripheral nerve stimulation for the treatment of occipital neuralgia.

Sciatic neurotmesis and periostitis ossificans progressiva due to a traumatic/unexpected glass injury: a case report

  • Berkay Yalcinkaya;Hasan Ocak;Ahmet Furkan Colak;Levent Ozcakar
    • Journal of Yeungnam Medical Science
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    • v.41 no.1
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    • pp.45-47
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    • 2024
  • Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/ tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

Riboflavin deficiency occurred in the broiler chicks (육용계 병아리에서 발생한 리보플라빈 결핍증)

  • Kim, Gye-Yeop
    • Korean Journal of Veterinary Research
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    • v.41 no.4
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    • pp.591-596
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    • 2001
  • The chicks from 6 field broiler farms revealed peripheral neuropathy including leg weakness, curled toes and drooped wings. Grossly distinctive enlargements of sciatic nerve, branchial nerve and lumbar nerve were observed in the chicks. Histologically nerve lesions consisted of demyelination of myelin sheaths, Schwann cell proliferation and swelling, and interstitial edema in the peripheral nerves of all birds examined. Axonal swelling and infiltration of small lymphocytes were observed, but not a primary lesion. After treatment of riboflavin, neurological disorder was markedly recovered. From these results, it is suggested that the peripheral nerve lesions in these cases were caused by dietary riboflavin deficiency.

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Concurrence of Malignant Peripheral Nerve Sheath Tumor at the Site of Complex Regional Pain Syndrome Type 1 - A Case Report -

  • Jeong, Yeong Ho;Choi, Eun Joo;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.160-163
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    • 2013
  • Malignant peripheral nerve sheath tumors (MPNSTs) are very rare sarcomas derived from various cells in the peripheral nerve sheath. Malignant peripheral nerve sheath tumors have a known association with neurofibromatosis type 1. Diagnosis of MPNSTs is difficult in patients with chronic pain, when MPNST occurs at an overlapping area of chronic pain. Therefore, the diagnosis can be missed unless clinicians pay attention to the possibility of this disease. Here in, we report a case of concurrent malignant peripheral nerve sheath tumor with complex regional pain syndrome type 1. A 44-year female patient, who was diagnosed with complex regional pain syndrome (CRPS) type 1 in her left ankle, visited our clinic because of aggravated pain. The cause of the aggravated pain was revealed as concurrent MPNST in the left common peroneal nerve territory, which overlapped the site of pain from CRPS.

Malignant Peripheral Nerve Sheath Tumor of Abdomen (복부에 발생한 악성 말초신경초종양)

  • So, Kyu-Sub;Lim, Yeung-Kook;Hong, Yong-Taek;Kim, Hoon-Nam
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.886-889
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    • 2011
  • Purpose: Malignant peripheral nerve sheath tumor without neurofibromatosis type 1 is very rare neoplasm. Development in the superficial soft tissue is exremely rare. Authors experienced one rare case of primary malignant peripheral nerve sheath tumor developed on abdomen. The clinical and histologic findings were described. Methods: An 83-year-old man visited hospital with an $11{\times}6.5{\times}4.5$ cm sized ulcerated and hemorrhagic mass on abdomen. The tumor was localized in abdominal skin and started growing 3 years ago. Results: Wide excision with safety margin of 2 cm and limberg flap was done. The postoperative biopsy revealed a malignant peripheral nerve sheath tumor. There was no evidence of recurrence of tumor for 16 months. Conclusion: Malignant peripheral nerve sheath tumor is an aggressive malignant tumor. An abrupt enlargement of size, ulceration and bleeding are suggestive of malignant chnages of the tumor. We recommand early wide excision with enough safety margin as treatment of malignant peripheral nerve sheath tumor.

A Large Malignant Peripheral Nerve Sheath Tumor in the Neurofibromatosis Patient: A Case Report (신경섬유종증 환자에 발생한 거대 악성말초신경초종의 치험례)

  • Choi, Dong Il;Seo, Dong Kuk;Jo, Woo Sung;Chung, Chul Hoon;Cho, Seong Jin
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.761-763
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    • 2006
  • Purpose: Malignant peripheral nerve sheath tumors most often arise from the anatomically discernible peripheral nerve or neurofibroma. Methods: A 55-year-old man had a rapidly growing pedunculated large mass on the sacrolumbar junction for 2 years. He has congenital neurofibromatosis type I. He had multiple caf-au-lait spots and multiple neurofibromas on the entire body. The mass developed from a subcutaneous nodule on the sacrolumbar junction and grew rapidly. The preoperative punch biopsy revealed a malignant peripheral nerve tumor. The mass was completely excised with 1 cm free margin above the deep fascial plane. Results: There was no evidence of recurrence of tumor for 19 months of follow-up examination. Conclusion: Malignant peripheral nerve sheath tumor is very rare and has unique feature. We report a successful case of malignant peripheral nerve sheath tumor with the review of the literatures.

Relationship between Pain Reaction and Electrical Stimulation of Peripheral Nerve with Special Reference of Stimulatory Parameters (말초신경 자극시 자극의 강도, 빈도 및 기간의 변화가 동통반응에 미치는 영향)

  • Paik, Kwang-Sea;Leem, Joong-Woo;Kim, In-Kyo;Lee, Seung-Il;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.19 no.2
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    • pp.227-232
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    • 1985
  • Previously, we had reported that the electrical stimulation of peripheral nerve with stimlatory parameters of 20 V strength and 2 Hz frequency for 60 min resulted in reducing the pain reaction. The present study was performed to evaluate if the pain reaction was affected by the peripheral nerve stimulation with different stimulatory parameters in the decerebrated cat. The flexion reflex was used as an index of the pain reaction. The reflex was elicited by stimulating the sural nerve (stimulus strength of 20 $V\;\times\;0.5$msec) and recorded as a compound action potential from the motor nerve innervated to the posterior biceps femoris muscle. The common perneal nerve was selected as a peripheral nerve on which the electrical stimulation of various intensities and frequencies was applied. The results are summarized as follows : 1) The peripheral nerve stimulation with 100 mV strength, regardless of frequencies, did not affect the pain reaction induced by the sural nerve stimulation. 2) When the stimulus of 1V intensity and slow frequency (2 Hz) was applied to the peripheral nerve for 30 min or 60 min, the pain reaction was significantly reduced comparing to the control. However, this reduced pain reaction by the peripheral nerve stimulation was not reversed by the injection of naloxone (0.02 mg/kg) 3) High frequency stimulus (60 Hz) of 1V intensity for 30 or 60 min did not show any effects of affecting the pain reaction. These results suggest that the stimulus of relatively high intensity (at least 1V) and low frequency (2 Hz) is needed to elicite the analgesic effect by the peripheral nerve stimulation. By the 1V stimulus, $A\delta$ nerve fiber is activated. Therefore, an $A\delta$ or smaller nerve fibers must be activated for showing analgesia by the peripheral nerve stimulation. However, the mechanism of analgesia by the $A\delta$ nerve activation alone was not related to the endogeneous morphine system since the reduced pain reaction by the $A\delta$ fiber activation alone was not reversed by the treatment of naloxone.

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Facial Nerve Decompression via Middle Fossa Approach : Report of Three Cases (말초성 안면마비에서 중두개와 접근법에 의한 안면신경 감압술 : 3례 보고)

  • Cho, Joon;Park, Sung-Ho;Kim, Jae-Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.479-485
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    • 2001
  • Objective : Several conservative treatments have been tried in peripheral facial nerve paralysis, because 80% of patients recover spontaneously. Surgical decompression may be helpful to the residual, medically intractable patients. We present here our experiences of facial nerve decompression via middle fossa approach, which seems to be one of good surgical therapeutic options for medically refractory peripheral facial nerve paralysis. Method : Three cases of medically intractable peripheral type facial paralysis were microscopically operated via middle cranial fossa approach to decompress the labyrinthine segment of the facial nerve and geniculate ganglion by searching landmarks of middle meningeal artery, greater superficial petrosal nerve and facial hiatus. Results : After operation, two cases of Bell's palsy improved substantially and one case of post-traumatic facial paralysis improved partially. Conclusion : This report is presented to describe the surgical facial nerve decompression via middle fossa for early control of peripheral type facial paralysis. Surgical decompression of edematous peripherally paralysed facial nerve could be preferred to conservative treatment in some patients although more surgical experience should be required.

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