China
Africa
Explore chapters and articles related to this topic
Side-effects
Published in Janet Rhys Dent, The Secret History of a Woman Patient, 2018
He explained that he was going to find out which nerves were affected. He placed electrodes on my hands and administered a series of small shocks. The tests confirmed that my radial nerve was crushed - radial nerve dysfunction or ‘radial neuropathy’ as the consultant called it. He told me that although he had seen only one other patient with this problem, he was optimistic.
Neurological Examination of Malingering
Published in Alan R. Hirsch, Neurological Malingering, 2018
Jose L. Henao, Khurram A. Janjua, Alan R. Hirsch
Patients with a history of falling and catching themselves with their outstretched hands during work will come to the clinic or hospital seeking secondary gains. A routine physician examination can prevent frivolous imaging studies that will come up negative, and allow the doctor to lead the patient to better psychological care. Radial nerve palsy complaints are common within neurological and primary care centers throughout the community. But how does one distinguish between true versus nonorganic disease? True disease is seen in patients that present with weakness in the wrist dorsiflexion (wrist drop) with fingers extended. Also, patients with true radial neuropathy would report sensory loss in the distribution of the radial nerve. Be leery of the patient who complains of radial nerve palsy without sensory loss in the dorsum of the hand with fifth digit spared. The supine catch test can also help with the differential diagnosis of malingering. In this test, patients with radial nerve palsy are instructed to supinate both affected and nonaffected hands and are asked to maintain that position. In true organic disease the affected hand will not drop and will maintain a palmar flexion (supine catch sign) due to an unopposed pull of the flexor compartment of the forearm (Sethi, Sethi, and Torgovnick, 2010) (Figure 3.6a). In false nerve damage the hand would drop straight down without the supine catch sign, suggesting malingering (Figure 3.6b). Patients will focus on the weakness instead of the actual physiology of the muscles, which will maintain different positions of the wrist.
Humeral diaphyseal fractures
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
Amy S. Wasterlain, Kenneth A. Egol
Radial nerve injury associated with closed fracture of the humerus is nearly always a neurapraxia or axonotmesis (axonal disruption) and rarely a neurotmesis (disruption of the entire nerve and sheath). Current best evidence suggests exploration may be unnecessary or even harmful. A recent meta-analysis comparing early operative versus nonoperative management of acute radial nerve palsy revealed no difference between the groups in radial nerve function, although surgically treated patients had more complaints.54 Another meta-analysis also reported equivalent nerve function between surgically and non-surgically treated radial nerve palsies, and found that 71% of patients recover spontaneously without intervention, with an 88% overall recovery rate including those who underwent surgical exploration.53 Ekholm et al. noted complete recovery in 89% of non-operatively and 73% of operatively treated patients, and partial or complete persistent radial nerve palsy in 13% of operatively treated patients.55 Complete clinical recovery of a compressive radial neuropathy occurs at a mean of 3.4 months but may take 6 or more months.56 Nerve conduction studies (NCS) and electromyography (EMG) earlier than 3 weeks after injury (prior to Wallerian degeneration) is not helpful and may be misleading. Thereafter, EMG/NCS cannot distinguish between recoverable and irrecoverable nerve injuries (e.g. neurotmesis). Electrodiagnostic testing can detect electrical signs of muscle function about 4–6 weeks before they are detectable on physical examination.57 Patients who would be satisfied with tendon transfers generally wait 6 and preferably 12 months for signs of improvement and then proceed with tendon transfers. Patients who prefer more sophisticated hand function might proceed to nerve exploration for potential nerve grafting if there are no clinical or electrophysiological signs of recovery 3–4 months after injury.
Sensory profiles are comparable in patients with distal and proximal entrapment neuropathies, while the pain experience differs
Published in Current Medical Research and Opinion, 2018
Brigitte Tampin, Jan Vollert, Annina B. Schmid
Data from patients with CTS were taken from the Oxford CTS cohort (up to October 2016). Patients with CTS were recruited through secondary neurophysiology and hand surgery clinics of local public hospitals, local print media and advertisements on public notice boards. The presence of CTS was determined using clinical17 and electrodiagnostic criteria19. Patients were excluded if electrodiagnostic tests suggested the presence of peripheral neuropathies other than CTS (e.g. ulnar or radial neuropathy), if another medical condition affecting the upper extremity or neck was present (e.g. CR), if a history of previous surgery or significant trauma to the upper limb or neck existed, or if CTS was related to diabetes or pregnancy. Using these criteria, 103 patients with CTS (63 female; mean age 60.2 ± 12.9 years) were included. To prevent selection bias, patients with CTS were deliberately not matched to patients with CR, but statistical analyses were adjusted for baseline differences (see below).
Update on complications and their management during transradial cardiac catheterization
Published in Expert Review of Cardiovascular Therapy, 2019
Joe Aoun, Laith Hattar, Khabib Dgayli, Gordon Wong, Tariq Bhat
Neurological injury is a rare complication of transradial catheterization because the anatomic position of the radial artery is distinct from the major nerves innervating the hand. Presenting as numbness or tingling of the hand, superficial radial neuropathy after transradial catheterization can be the result of compression of the superficial branch of the radial nerve and is reported at an incidence of 1.52% [16]. This is typically transient and self-limiting. Nerve damage, which may be more limiting for patients, can occur as a result of acute arterial occlusion or direct penetrating trauma, though this is exceedingly rare, with an incidence of 0.16% [16].
Polyneuropathy and the sural/radial sensory nerve action potential ratio in primary Sjögren’s syndrome
Published in Neurological Research, 2020
Yasemin Eren, Nese Gungor Yavasoglu, Cem Ozisler
Inclusion criteria were as follows: Age>18 years; normal neurological examination;sural sensory nerve SNAP value >6 µV;and radial sensory nerve SNAP value>15 µV. Patients who had a predisposing factor for polyneuropathy such as endocrinologic, hematologic, oncologic, or vasculitic diseases, or electrophysiologically diagnosed polyneuropathy, radiculopathy, plexopathy, sciatic neuropathy, or isolated radial neuropathy were excluded from the study.