Treatment Of Entrapment Neuropathy Research Articles

Transcranial direct current stimulation reduces ischemia-induced sensory disturbance in the hands of healthy subjects.

The treatment of entrapment neuropathies, such as carpal tunnel syndrome or cubital tunnel syndrome, has significant challenges that have yet to be solved. To a large extent, the success of the treatment of peripheral nerve damage is dependent on brain plasticity during the recovery process. Recently, noninvasive brain stimulation procedures, such as transcranial direct current stimulation (tDCS), to modulate brain activity have been developed. This study aimed to determine whether tDCS can improve artificially induced ischemic sensory disturbances in the finger. Ten right-handed, healthy volunteers, with an average age of 25.5 years, participated in this study. A rubber bandage at the base of the right index finger was used to induce a regional sensory disturbance for 30 minutes. An anodal tDCS was applied over their left M1 area 15 minutes into the session. The current perception threshold (CPT) in the index and little finger pad was evaluated using the PainVision system and used as a measure of the sensory threshold. In the index finger, the CPT increased significantly with time, a finding that was absent after tDCS application. It has been reported that anodal tDCS over M1 primarily modulates the functional connectivity of sensory networks, and our findings demonstrate that it improved ischemia-induced sensory disturbances. Modulating the central nervous system using tDCS represents a potential avenue for treating entrapment neuropathies.

Assessing Sciatic Nerve Excursion and Strain with Ultrasound Imaging during Forward Bending

Entrapment neuropathies affecting the sciatic nerve tract may adversely affect neural biomechanical features such as excursion and strain. There is a paucity of in vivo evidence examining the effects of forward bending upon sciatic nerve excursion and strain. The purpose of this study was to assess the reliability of ultrasound imaging in measuring sciatic nerve excursion and strain during forward bending movements. Secondary aims were to quantify sciatic nerve excursion and strain during forward bending movements and to assess the relationship between sciatic nerve excursion and movements of the hip and lumbar spine. The reliability of measuring sciatic nerve excursion was high to excellent whilst measurement of sciatic nerve strain was moderate. The amount of hip flexion, during forward bending, was a strong predictor of sciatic nerve excursion. These findings will support clinicians in the assessment and treatment of entrapment neuropathies, in addition to providing a foundation for future research.

THU0562 Low-Level Laser Therapy with Wrist Splint in the Treatment of Carpal Tunnel Syndrome: A Double-Blinded Randomized Controlled Trial

BackgroundLow-level laser therapy (LLLT) has been found to have beneficial effects in treatment of entrapment neuropathy and various musculoskeletal conditions.ObjectivesThe aim of the study was to evaluate the efficacy of...

Further Evidence for Treatment of Recalcitrant Neuropathy of the Upper Limb With Autologous Vein Wrapping

The treatment of entrapment neuropathy in the upper extremity with surgical decompression has generally provided good results. Recurrence of symptoms, however, is not uncommon, and its management is both challenging and difficult. Autologous vein graft wrapping is an alternative technique, and it is recommended for the treatment of recalcitrant upper limb nerve compression in which 2 or more previous surgical procedures have failed to resolve the problem. Each patient underwent both subjective and objective evaluation. To our knowledge, this is the largest reported single series of vein wrapping cases in the upper limb outside the United States and the first to report results using the well-validated patient evaluation measure.

The Use of Low-Energy Radial Shockwave in the Treatment of Entrapment Neuropathy of the Medial Calcaneal Nerve: A Pilot Study

Medial calcaneal nerve entrapment is a well-recognized cause of heel pain. In addition, the development of an amputation neuroma of the medial calcaneal nerve from prior heel surgery via an open incision on the medial aspect of the heel is a serious common postoperative complication and can be extremely difficult to treat. This preliminary pilot study demonstrates that the use of low-energy extracorporeal shockwave is safe and efficacious in the treatment of this disorder without the morbidity associated with denervation surgery, which would be one of the most common methods to treat this complicated situation. Four patients, 2 with bilateral affectation, for a total of 6 medial calcaneal nerves, had a series of treatments with low-energy radial shockwave with the Swiss DolorClast machine. All 4 patients had improvement in their pain scores, to the point that none elected surgical treatment, and there were no complications.

Hormone replacement therapy in hypothyroidism and nerve conduction study

Objectives To evaluate the electrodiagnostic evidence of peripheral nerve dysfunction in patients with hypothyroidism before and after hormone replacement treatment. Materials and methods Forty patients aged above 18 years diagnosed with hypothyroidism were included in our study. Patients with FT4 levels below 11.6 pmol/l and TSH levels above 4.2 IU/ml were accepted as hypothyroidic. Electrodiagnostic evaluation was performed at the onset of the study and after 3 months. Electrodiagnostic evaluation included motor and sensory nerve conduction studies, and F wave. Results The differences between pre- and post-treatment FT4, FT3 and TSH values were found to be statistically significant. At the onset, electrophysiological evaluation revealed carpal tunnel syndrome in 15 patients and polyneuropathy in seven patients; whereas 18 patients were found normal in these respects. After treatment, the electrodiagnostic evaluation revealed that 35 patients were normal, while only two patients had carpal tunnel syndrome and three patients had polyneuropathy. The differences between before and after treatment values of median motor distal latency and amplitude, median sensorial nerve conduction velocity, tibial motor nerve conduction velocity and sural sensory nerve conduction velocity were found to be statistically significant. Conclusion The results of the control evaluation after treatment demonstrated that the findings related to entrapment neuropathy and polyneuropathy in hypothyroid patients can be reversible in a period of 3 months if appropriate hormone replacement treatment can be obtained. Especially in the treatment of entrapment neuropathy in hypothyroidism, the chance of medical treatment must be given to patients before considering surgical treatment.

Treatment of recurrent compressive neuropathy of peripheral nerves in the upper extremity with an autologous vein insulator.

The treatment of entrapment neuropathy in the upper extremity with surgical decompression has generally provided good results. Recurrence of symptoms, however, is not uncommon and its management is both challenging and difficult. Nineteen patients with recurrent carpal tunnel and cubital tunnel syndrome were treated with the vein wrapping technique using the autogenous saphenous vein. The average number of surgeries before vein wrapping was 3.3. The mean patient age was 53 years (range, 28-75 years) and the mean follow-up period was 43 months (range, 24-78 months). All patients reported reduction in pain and the sensory disturbances secondary to the compression of the median or ulnar nerve. Two-point discrimination and electrodiagnostic findings also improved.

The Surgical Treatment of Entrapment Neuropathies of the Lower Extremity

The Surgical Treatment of Entrapment Neuropathies of the Lower Extremity