Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Entrapment neuropathies are a common cause of pain and disability in both the upper and lower extremities. Diagnosis is based on clinical presentation and electrodiagnostic evaluation. Treatment consists of conservative measures to relieve pressure and pain and in some cases surgical freeing of the nerve.
 ...
PMID:Entrapment neuropathies. Differential diagnosis and management. 396 55

Compression neuropathy of the ulnar nerve at the elbow is treated by neurolysis and excision of the medial humeral epicondyle without transposing the ulnar nerve anteriorly. Removal of the medial humeral epicondyle is not associated with loss of motion at the elbow or reduction in strength of finger or wrist flexion because of the multiple muscle origins, as well as the firm healing of the common flexor origin to the resected bone surface. Thirty cases were treated between 1965 and 1977. Treatment halted progression of the disease in all patients. Discomfort and pain subsided in every instance. All 12 of the grade I patients had return of normal nerve function. Four of the 12 grade II patients were left with some weakness. Four of the six grade III patients improved to grade II status. None required secondary procedures on the ulnar nerve.
 ...
PMID:Treatment of compression neuropathy of the ulnar nerve at the elbow by epicondylectomy and neurolysis. 741 84

Compression neuropathy of the lateral femoral cutaneous nerve (meralgia paresthetica) leads to pain and dysesthesia in the anterolateral thigh. Over a period of 23 1/2 years, 29 patients (33 procedures) were operated on after failure of conservative treatment: 18 patients (20 procedures) underwent neurolysis of the nerve, and in 11 the nerve was transected. The 33 procedures were necessary because 1 patient had bilateral meralgia paresthetica and there were 3 recurrences with persisting pain. The average follow-up was 32 months after neurolysis and 87 months after transection. Complete or partial pain relief was found in 72% after decompression and in 82% after transection of the nerve.
 ...
PMID:[Meralgia paraesthetica and its surgical treatment]. 756 73

Compressive lesions of the suprascapular nerve produce weakness and atrophy of the supra- and infraspinatus muscles and a poorly defined aching pain along the posterior aspect of the shoulder joint and the adjacent scapula. Entrapment neuropathy of the suprascapular nerve is fairly common whereas tumorous lesions are rare; among the latter ganglion cysts are frequently seen. An isolated solitary schwannoma of the suprascapular nerve presenting with atypical neuralgic pain is exceptional. The location of a schwannoma under the firm deep cervical fascia in the posterior triangle of the neck is implicated in the genesis of neuralgic pains mimicking the suprascapular entrapment syndrome. One such case is reported with discussion of the relevant clinical features.
 ...
PMID:Schwannoma of the suprascapular nerve presenting with atypical neuralgia: case report and review of the literature. 1114 84

Entrapment neuropathy of the suprascapular nerve with pain and weakness of the affected shoulder is a rare clinical entity for which several treatment modalities have been reported. Instead of trying to evacuate the cyst from within the joint, the cyst was approached through the subacromial space after subacromial bursectomy, exposure of the spinoglenoid notch, and insertion of a small retractor through an additional posterior portal. This allowed retraction of the infraspinatus muscle together with the inferior branch of the suprascapular nerve for better visualization. After localization of the cyst and nerve, the membrane was incised and the entire viscous contents could be aspirated with a shaver. The intra-articular area of labral detachment was then repaired like a posterior aspect of a SLAP II lesion. The technique described combines the advantages of open and arthroscopic surgery, allowing one to address the underlying intra-articular pathology, completely evacuate the ganglion cyst, and protect the suprascapular nerve.
 ...
PMID:Combined intra- and extra-articular arthroscopic treatment of entrapment neuropathy of the infraspinatus branches of the suprascapular nerve caused by a periglenoidal ganglion cyst. 1734 85

Compression neuropathy of the posterior tibial nerve (PTN) and its branches in the tarsal tunnel is called tarsal tunnel syndrome (TTS) and has various aetiologies. Space-occupying lesions in the tunnel, such as neurilemomas, can cause such a disease. When a neurilemoma occupies the tarsal tunnel, it can compress the PTN directly or indirectly and results in restriction of the tunnel volume. Symptoms due to this restricted volume may vary in TTS. A case of neurilemoma of PTN in tarsal tunnel with a complaint of posteromedial ankle intermittent pain in a 20-year-old patient is presented here. A mass was observed at the ankle posteromedially during clinical examinations and the patient underwent magnetic resonance imaging (MRI) and radiological investigation. Radiographic evaluation of the ankle was normal. However, MRI was revealed a mass adjacent to the PTN in the tarsal tunnel. An ovoid, smooth-surfaced, encapsulated and eccentrically localized mass in the PTN was detected at surgery. The mass was excised from the nerve and pathological evaluation revealed a neurilemoma (schwannoma). Neurilemomas arising from the PTN in the tarsal tunnel should always be kept in mind as a differential diagnosis when a patient complains of a posteromedial ankle pain. Since it is a space-occupying lesion and encapsulated tumor in the tarsal tunnel, simple surgical resection is curative without a distinct morbidity.
 ...
PMID:Tarsal tunnel syndrome associated with a neurilemoma in posterior tibial nerve: a case report. 2030 34

After experimental nerve injuries that extensively disrupt axons, such as chronic constriction injury, immune cells invade the nerve, related dorsal root ganglia (DRGs), and spinal cord, leading to hyperexcitability, raised sensitivity, and pain. Entrapment neuropathies, such as carpal tunnel syndrome, involve minimal axon damage, but patients often report widespread symptoms. To understand the underlying pathology, a tube was placed around the sciatic nerve in 8-week-old rats, leading to progressive mild compression as the animals grew. Immunofluorescence was used to examine myelin and axonal integrity, glia, macrophages, and T lymphocytes in the nerve, L5 DRGs, and spinal cord after 12 weeks. Tubes that did not constrict the nerve when applied caused extensive and ongoing loss of myelin, together with compromise of small-, but not large-, diameter axons. Macrophages and T lymphocytes infiltrated the nerve and DRGs. Activated glia proliferated in DRGs but not in spinal cord. Histologic findings were supported by clinical hyperalgesia to blunt pressure and cold allodynia. Tubes that did not compress the nerve induced only minor local inflammation. Thus, progressive mild nerve compression resulted in chronic local and remote immune-mediated inflammation depending on the degree of compression. Such neuroinflammation may explain the widespread symptoms in patients with entrapment neuropathies.
...
PMID:Local and remote immune-mediated inflammation after mild peripheral nerve compression in rats. 2377 Dec 20

The superficial peroneal nerve presents great anatomic variability regarding its emergence from the crural fascia, course, branching pattern, and distribution area. Entrapment neuropathy of the superficial peroneal nerve has been documented in the published data, resulting in pain and paresthesia over the dorsum of the foot. We report a case of a female cadaver in which an accessory superficial peroneal sensory nerve was encountered. The nerve originated from the main superficial peroneal nerve trunk, proximal to the superficial peroneal nerve emergence from the crural fascia, and followed a subfascial course. After fascial penetration, the supernumerary nerve was distributed to the skin of the proximal dorsum of the foot and lateral malleolar area. A potential entrapment site of the nerve was observed at the lateral malleolar area, because the accessory nerve traveled through a fascial tunnel while perforating the crural fascia, and presented with distinct post-stenotic enlargement at its exit point. The likely presence of such a very rare variant and its potential entrapment is essential for the physician and surgeon to establish a correct diagnosis and avoid complications during procedures to the foot and ankle region.
...
PMID:Potential entrapment of an accessory superficial peroneal sensory nerve at the lateral malleolus: a cadaveric case report and review of the literature. 2395 64

Entrapment neuropathy of the supraclavicular nerve is rare and, when it occurs, is usually attributable to branching of the nerve into narrow bony clavicular canals. We describe another mechanism for entrapment of this nerve with the aberrant muscle; supraclavicularis being found during the routine dissection of an embalmed 82-year-old cadaver. Our report details a unique location for this rare muscular variation whereby the muscle fibres originated posteriorly on the medial aspect of the clavicle before forming a muscular arch over the supraclavicular nerve and passing laterally towards the trapezius and acromion. We recommend that in clinical instances of otherwise unexplained unilateral clavicular pain or tenderness, nerve compression from the supraclavicularis muscle must be borne in mind.
...
PMID:Supraclavicularis proprius muscle associated with supraclavicular nerve entrapment. 2544 16

Entrapment neuropathies of the fibular nerve and its branches are often underdiagnosed due to the lack of reliable diagnosis using clinical examination and electrophysiologic evaluation. Most fibular nerve compressions may be classified into 2 broad categories: (a) mechanical causes, which occur at fibrous or fibro-osseous tunnels, and (b) dynamic causes related to nerve injury during specific limb positioning. Foot drop resulting from weakness of the dorsiflexor muscles of the foot is a relatively uncommon presentation and closely related to L5 neuropathy caused by a disc herniation. However, we herein describe a rare case of usually painless foot drop triggered by a cyst at the proximal tibiofibular joint compressing the deep fibular nerve. The presence of multilevel disc diseases made the diagnosis more difficult. Foot drop is highly troubling, and health care providers need to broaden their search for the imperative and overlapping causes especially in patients with painless drop foot, and the treatment is variable and should be directed at the specific cause. The magnetic resonance imaging (MRI), including high-resolution and 3D MR neurography, allows detailed assessment of the course and anatomy of peripheral nerves, as well as accurate delineation of surrounding soft-tissue and osseous structures that may contribute to nerve entrapment. Knowledge of normal MRI anatomy of the nerves in the knee and leg is essential for the precise assessment of the presence of peripheral entrapment conditions that may produce painless or painful drop foot. In conclusion, we stress the importance of preoperative anatomic mapping of entrapment neuropathies to minimize neurological complications.Key words: Foot drop, fibular nerve, ganglion cyst, proximal tibiofibular jointFoot drop, fibular nerve, ganglion cyst, proximal tibiofibular joint.
Pain Physician
PMID:Ganglion Cyst at the Proximal Tibiofibular Joint in a Patient with Painless Foot Drop. 2790 45


1 2 Next >>