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Peripheral nerve disorders
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Michael Fox, David Warwick, H. Srinivasan
High lesion occur with fractures of the humerus or after prolonged tourniquet pressure. There is an obvious wrist drop, due to weakness of the radial extensors of the wrist, as well as inability to extend the metacarpophalangeal joints or elevate the thumb (Figure 11.19). Sensory loss is limited to a small patch on the dorsum around the anatomical snuffbox.
Peripheral Nerve Injuries
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
High lesions occur with fractures of the humerus or after prolonged tourniquet pressure. They are also seen in patients who fall asleep with the arm dangling over the back of a chair (Saturday night palsy). There is an obvious wrist-drop due to weakness of the wrist extensors and a small patch of sensory loss on the back of the hand at the base of the thumb.
Nerve and Root Lesions
Published in John W. Scadding, Nicholas A. Losseff, Clinical Neurology, 2011
Tim Fowler, Nick Losseff, John Scadding
The nerve is supplied by C7 and to a lesser extent C6 and C8. It supplies the triceps, brachioradialis, supinator, wrist and finger extensors and the long abductor of the thumb. Sensation may be impaired on the posterolateral aspect of the forearm or with more distal lesions over the dorsum of the web between the thumb and index finger. An acute wrist drop is the major symptom and sign. More proximal lesions cause additional weakness of triceps.
Influence of clinical experience on accuracy and safety of obliquus capitus inferior dry needling in unembalmed cadavers
Published in Physiotherapy Theory and Practice, 2022
Gary A. Kearns, Troy L. Hooper, Jean-Michel Brismée, Brad Allen, Micah Lierly, Kerry K. Gilbert, Timothy J. Pendergrass, Deborah Edwards
While it is not the intent to hit the spinal cord, clinicians should consider potential symptoms or consequences that may occur with attempts to dry needle the OCI. There is a paucity of published dry needling literature discussing potential symptoms of striking the spinal cord or nerves with small gauge needles, however the patient may experience sharp electric pain (McEvoy, 2018). Although epidural injections use larger gauge, hollow needles, anesthesiologists describe transient neurologic symptoms such as radiating radicular pain and paresthesia secondary to striking neural tissue with the needle or from injection of anesthetic that usually resolves within days (Hewson, Bedforth, and Hardman, 2018). More serious adverse events appear to be secondary to small gauge needles broaching the spinal canal and epidural space as opposed to direct trauma to the spinal cord. Two recent cases (Berrigan, Whitehair, and Zorowitz, 2019; Lee, Lee, and Jo, 2011) described acute epidural hematomas following cervical dry needling. One case (Berrigan, Whitehair, and Zorowitz, 2019) was managed conservatively while the other case (Lee, Lee, and Jo, 2011) resulted in quadriparesis requiring surgical decompression. Although these involved needling to the lower cervical spine, a case report (Yazawa et al., 1998) of acupuncture to the nuchal region describes a high epidural abscess, soft tissue inflammation and osteomyelitis that was treated conservatively with antibiotics. While there are no case reports or published long-term consequences of striking the spinal cord, a recent case report discusses a patient developing wrist drop following dry needling injury to the radial nerve (McManus and Cleary, 2018), suggesting motor compromise may be possible.
Exosomal TAR DNA binding protein 43 profile in canine model of amyotrophic lateral sclerosis: a preliminary study in developing blood-based biomarker for neurodegenerative diseases
Published in Annals of Medicine, 2023
Penelope Pfeiffer, Joan R. Coates, Yajaira M. Esqueda, Andrew Kennedy, Kyleigh Getchell, Myra McLenon, Edina Kosa, Abdulbaki Agbas
ALS is an incurable and fatal disease with a patient survival rate of 3–5 years once diagnosed [10]. In most patients, the symptoms begin in the lower limbs [11,12]. Patients often complain of tripping, stumbling, foot drop, or a ‘slapping’ gait. Upper limb involvement includes decreased dexterity in the fingers, cramping, stiffness, weakness, and wrist drop [13]. Early diagnosis of ALS is very difficult, which can delay the time to treatment [14]. Establishing a blood-based biomarker(s) will help clinicians with early diagnosis and initiating timely treatment. The pharmaceutical intervention with well-timing may improve the quality of life and lifespan for ALS patients.
Risk assessment of elevated blood lead concentrations in the adult population using a decision tree approach
Published in Drug and Chemical Toxicology, 2022
Alireza Amirabadizadeh, Samaneh Nakhaee, Omid Mehrpour
Clinical symptoms of elevated blood lead concentration (EBLC) include fatigue, abdominal pain lead colic, memory loss weakness, irritability, constipation, anorexia, fine tremors, and wrist drop (Weiss et al. 2017, Gebrie et al.2014).