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Compression Neuropathies
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
The median nerve gives a recurrent motor branch at the distal end of flexor retinaculum to innervate the abductor pollicis brevis muscle, first two lumbricals and opponens pollicis muscles. The median nerve then divides into the digital nerves that provide sensation to the thumb and index finger, middle finger and radial half of the ring finger.
Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Musculoskeletal complications of diabetes include carpal tunnel syndrome, Dupuytren contracture, adhesive capsulitis, and sclerodactyly. Carpal tunnel syndrome is compression of the median nerve along its course through the carpal tunnel in the wrist. Dupuytren contracture is progressive contracture of the palmar fascial bands, resulting in finger flexion deformities. Adhesive capsulitis is commonly known as frozen shoulder, associated with shoulder pain and stiffness. Sclerodactyly is a localized thickening and tightness of the skin on the fingers or toes.
Neurology
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
The median nerve supplies a number of muscles in the forearm and hand, and sensation to the front of the thumb, index, middle and half the ring finger. It lies in the mid line at the front of the elbow and is overlain by a large vein, a common target for the venepuncturist taking blood. If the needle is dug in too hard and too deep it may puncture the median nerve, producing immediate pain, tingling and numbness in the hand, which may then go on to produce permanent weakness and, in particular, causalgia.
Effect of adding neostigmine to bupivacaine for ultrasound-guided supraclavicular brachial plexus block in forearm surgeries a randomized, blinded, controlled study
Published in Egyptian Journal of Anaesthesia, 2023
Abeer A.M. Hassanin, Ibrahim A. Youssef, Heba A. A. Mohamed, George A. Hanna
In disagreement with our results, Van Elstraete et al., 2001 [10] 34 ASA I or II patients having an elective ambulatory carpal tunnel surgery were the subject of the study. The median nerve was located utilizing a peripheral nerve stimulator and an axillary brachial plexus block was done. Epinephrine 5 mcg mL-1 and 1.5% lidocaine 450 mg were given to all patients. Patients were split into one of two groups at random. In one group, 500 mcg of neostigmine was added, while in the other, 1 mL of saline was added. They concluded that neostigmine does not appear to be of clinical value for peripheral nerve blocks after discovering that the need for additional analgesia did not substantially vary between groups, as well as that VAS scores and the incidence of adverse impacts did not substantially differ.
Monophasic synovial sarcoma mimicking schwannoma: a case report of a rare peripheral nerve tumor and literature review
Published in Neurological Research, 2023
Crescenzo Capone, Alessandra Turrini, Giulio Rossi, Vanni Veronesi, Carlo Sacco, Guido Staffa
We report the case of a 64-year-old, right-hand dominant man, with no significant past medical history, who came to our attention due to a slow-growing painful right axillary neoformation. The patient had already noticed it in previous years, but he did not give it much importance. On medical examination, we observed a moderately tender mass on the right axillary cave, approximately 25 mm in size, at the level of the deltopectoral junction. The patient did not show any motor or sensory impairments and the neurovascular examination was within normal limits. No history of neurofibromatosis type 1 (NF1) was reported or diagnosed. Electrodiagnostic tests, including electromyography and a nerve conduction study of the median nerve, were within normal limits. A first diagnosis as schwannoma of the right brachial plexus was made and the patient underwent ultrasonography and magnetic resonance imaging (MRI) with intravenous contrast infusion which showed a 3.1 × 2.2 × 2.0 cm, ovoid, lobular, heterogeneous mass arising from the posterior cord of the right brachial plexus. During T1- and T2-weighting, the mass was brighter than skeletal muscle with intense contrast enhancement (Figure 1). The radiologist’s impression confirmed the hypothesis of a probable neurofibroma or schwannoma.
Prevalence and risk factors for self-reported symptoms of carpal tunnel syndrome among hospital office workers: a cross-sectional study
Published in International Journal of Occupational Safety and Ergonomics, 2023
Carpal tunnel syndrome (CTS) occurs as a result of compression of the median nerve in the carpal tunnel at the wrist joint level and is the most common peripheral nerve entrapment disease. CTS is not a simple condition but a serious cause of disability, and is defined as the upper extremity musculoskeletal disease associated with the highest cost among working-age patients in relation to taking sick leave, decreased productivity and personal financial losses [1]. The US Bureau of Labor Statistics reported that all musculoskeletal problems were responsible for an estimated 32.2 cases and an average 12 days off work per 10,000 workers in 2015, in all industries in the USA, while CTS accounted for the highest number of workdays lost (on average, 28 days off work per case) [2]. Early detection of CTS can also be a critical factor affecting the return to work. Workers with a correct and early diagnosis of CTS were found to be much more likely to return to work than workers diagnosed weeks or months later [3].