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The Gallbladder (GB)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Sciatic entrapment neuropathy more commonly damages the fibular division. The fibular component of the sciatic nerve, in contrast to its tibial partner, occupies a more superficial position with less supportive connective tissue to protect it from compression. In addition, while the positions of both are fixed at the sciatic foramen, the fibular portion is also tethered at the fibular head. Thus, the fibular nerve has less opportunity for mobility. Sciatic neuropathy mimics distal common fibular neuropathy in that both may manifest as foot drop secondary to loss of nerve supply to the anterior (cranial) tibialis muscle. The most common cause of sciatic neuropathy occurs when the surgeon either overstretches or directly traumatizes the nerve during total hip arthroplasty. Piriformis muscle syndrome, described above, entraps the sciatic as well.
Bilateral peroneal nerve palsy secondary to prolonged sitting in an adolescent patient
Published in International Journal of Neuroscience, 2022
Şükran Güzel, Selin Ozen, Sacide Nur Coşar
Electrodiagnostic testing is of diagnostic and prognostic value in children with suspected PNP. In both adult and paediatric cases of PNP, the pathophysiology of nerve injury mostly involves axonal degeneration rather than demyelination [11]. In this case; clinical, radiological and electromyographic findings ruled out differential diagnoses of lumbosacral plexopathy, L5 radiculopathy, bilateral sciatic neuropathy, polyneuropathy and myopathy. The electromyogram demonstrated bilateral axonal PNP. Segmental demyelination tends to carry a better prognosis for early recovery when compared to axonal injury as axonal recovery necessitates nerve regeneration [4]. However, in this patient the clinical findings on follow-up were indicative of sufficient axonal regeneration. This good level of recovery may have been in part due to the PT followed by the continuation of the HEP [12].
Absent sural responses in tethered cord syndrome
Published in The Journal of Spinal Cord Medicine, 2021
Elia G. Malek, Johnny Salameh, Nour Estaitieh, Achraf Makki
To our knowledge, the electrophysiological finding of unilaterally absent sural responses as in our cases has not been previously reported in the literature. The exclusion of sensory polyneuropathy, sciatic neuropathy, and in setting of no previous history of local trauma to the lower extremity (traumatic isolated sural neuropathy) leads us to believe that a selective nerve fiber injury in the structures of the dorsal root ganglia (DRG) or distally lying structures containing sensory fibers had led to this finding. This can be induced by a repetitive chronic increase in traction of the caudal spinal cord inducing metabolic and electrical dysfunction in the lumbosacral gray matter, with greater stretch in lower segments and little effect on cephalic segments above the lowest pair of dentate ligaments. Various segments of the human lumbosacral cord may elongate slightly at different rates with post-ganglionic stretch effect of the spinal nerves above the threshold of its tolerance. Such differential elongations may be influenced by the duration of the traction effect, presence of arachnoid adhesion and fibrosis, and spinal curvature.9
Peroneal neuropathy and bariatric surgery: untying the knot
Published in International Journal of Neuroscience, 2020
Mohamad Y. Fares, Zakia Dimassi, Jawad Fares, Umayya Musharrafieh
Electrodiagnostic examinations like nerve conduction studies, EMG and ENMG, are of paramount importance in confirming the diagnosis of peroneal neuropathy, excluding alternative diagnoses, and predicting prognosis [36]. Nerve conduction studies can provide high efficacy in detecting and analyzing peroneal nerve insults [19, 36]. If the lesion is due to demyelination, a focal slowing or conduction block can be witnessed, whereas if the lesion is due to axonal degeneration, a decrease in the amplitudes of action potentials would be observed [36]. EMG and ENMG are significantly helpful as well, and aid in confirmation of the diagnosis and localization of the lesion. Muscles that are commonly examined include one muscle innervated by the superficial peroneal nerve, two muscles innervated by the deep peroneal nerve, the tibialis posterior, the medial gastrocnemius, and the short head of the biceps femoris [36,37]. In case any of the examined muscles show an abnormal finding, muscles supplied by the nerve root L5 and not the peroneal nerve are examined to exclude sciatic neuropathy, radiculopathy, and lumbosacral plexopathy [37].