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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The validity of twelve provocative tests for carpal tunnel syndrome (CTS) in a random sample of 504 people from the general population was assessed. 50 woke up at night due to paraesthesiae (with or without numbness or pain) in the fingers innervated by the median nerve (CTS symptoms) in 93 hands. CTS was neurophysiologically confirmed in 28 subjects (44 hands)--a prior probability for CTS of 47%. All clinical diagnostic tests had a low validity. Posterior probability of CTS ranged from 35 to 70% for positive test results and from 41 to 62% for negative test results. A combination of three tests with relatively high validity (paresis of abductor pollicis brevis muscle, hyperpathia, and flick sign) did not significantly change the probability of CTS. Patients with CTS symptoms should be referred directly for neurophysiological examination.
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PMID:Efficacy of provocative tests for diagnosis of carpal tunnel syndrome. 196 84

Acupuncture has been practiced in the treatment of many diseases in Japan. "Okibari" is one of the procedures in acupuncture treatment: a fine stainless steel or silver needle is inserted into the subcutaneous tissue through the skin, to remain in the subcutaneous tissue. A 57-year-old pharmacist was knocked down by a motorcycle in 1971, since then moderate weakness of left extremities and stiffness of muscles have remained as sequelae. She was consequently treated with acupuncture. Many small needles were inserted permanently in the nuchal, occipital and other areas of the body ten to twelve years before she developed gradual clumsiness and dysesthesia in her right hand in 1984. When she was admitted for the first time in 1985, neurological examination revealed left Horner's syndrome and diminished deep sensation in her right extremities with pseudo-athetosis of her right hand, along with spastic paresis of left extremities and right carpal tunnel syndrome. An old needle which had strayed into left dorsal medulla was considered to be responsible for these symptoms. In 1988 loss of pain and temperature sensation in the right side of her body below the shoulder, and diminished deep sensation of left extremities were appended, and weakness of her left extremities became aggravated. Pseudo-athetosis of her right hand was seen less prominently. In plain X-ray films many needle shadows were visualized. On CT scan needle shadows could be seen also in the left dorsal medulla, right cerebellum and in the subarachnoid space of left dorsal C1-C2 level.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Acupuncture needles, straying in the central nervous system and presenting neurological signs and symptoms]. 227 62

Common peripheral neurogenic lesion in various locations and of different origins were examined thermographically and the results were compared with those obtained by clinical and electromyographic methods. Lesions in the regions of the N. ulnaris and N. medianus can, except in the case of carpal tunnel syndrome, be identified without difficulty by thermography. The results obtained in the case of paresis of the radialis are non-specific, and thermographic examination of radicular lesions are also sometimes ambiguous. Damage in the plexus-brachialis and root region yield impressive results which, however, are not particularly useful.
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PMID:[Thermographic studies with fluid crystals in peripheral nerve damage]. 300 6

On the basis of our own patients, the anamnestic data and the neurological constellation in late radiogenic paresis (the most frequent peripheral nervous condition in treatment of mammary carcinoma) are described. A comparison with the situation in metastatic infiltration of the brachial plexus shows the great difficulties in differential diagnosis. Pain can be observed more frequently in metastatic plexus infiltration. The presence of a Horner syndrome can be regarded as decisive evidence for recurrent growth of a carcinoma. If a Horner syndrome is absent, tumor growth can be demonstrated conclusively only by biopsy or surgical exploration. The most frequent condition which is not connected with mammary carcinoma and its followup treatment, but which can stimulate a late radiogenic paresis of the brachial plexus is the carpal tunnel syndrome. Whereas a certain differentiation is not always possible on the basis of the anamnesis and clinical findings, a clear discrimination is possible by means of electrophysiological investigation techniques.
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PMID:[Lesions of the peripheral nervous system in the treatment of breast cancer]. 618 90

We present a mother and 2 children with congenital myopathy whose clinical signs were facial paresis in all three, and mild involvement of the lower extremities in the mother and one son. All three presented skeletal abnormalities, hypertelorism, arched palate, retraction of the Achilles tendon or short neck. Symptoms were not progressive and muscle biopsies showed central cores and nemaline rods in the mother and only nemaline rods in the 2 sons. The mother also suffered carpal tunnel syndrome, as had other members of the family as the result of autosomal dominant inheritance.
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PMID:[Congenital myopathy with cores and nemaline rods in one family]. 775 14

Endoscopic carpal tunnel release is a new technique for treatment of carpal tunnel syndrome. The benefits of this procedure are a small skin wound with less local pain, the fact that the hand can quickly be used again, and earlier return to work or other activities. We present the preliminary results of the 3-month follow-up of 88 patients out of a prospective study of 100 patients. All patients were operated on using the one-port technique. Six additional decompressions had to be abandoned and open release was performed. Of the patients with pain, 73.6% (68/88) were completely pain-free and in 13.2% (9/68) pain improved in more than 50%. Subjective symptoms like paresthesia and numbness of the hand disappeared completely in 77.2% (64/83). Sensory deficits disappeared in 50% (33/66). Ten of 17 patients with preoperative paresis of the abductor pollicis brevis muscle and 11/14 with paresis of the opponens pollicis muscle had normal motor function 3 months after the operation. The complication rate concerning nerve lesions was 2.3%. The return to work time was 21 days (range 3-49 days). According to clinical symptoms, our preliminary results do not seem to have any benefits compared to the conventional open technique, and the costs for the endoscopic procedure are markedly higher. The complication rate after the learning curve period is approximately the same as open carpal tunnel release.
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PMID:[Experiences with endoscopic surgery in treatment of carpal tunnel syndrome. Preliminary results of a prospective study]. 931 84

Nerve compression syndromes caused by non-neural tumours or tumour-like lesions are rare. We retrospectively reviewed 541 consecutive patients operated on by the same surgeon to study nerve compression syndromes in the forearm and hand. There were 414 due to nerve compression and 127 caused by tumours. Twenty-two patients showed compression neuropathy associated with 17 tumours and six tumour-like lesions, with 13 different pathological types. The most common types were fatty and vascular tumours. Twenty-one tumours were extraneural and one was intraneural. The median nerve was affected in nine cases, the ulnar nerve or the dorsal sensory branch of the ulnar nerve in five cases, the posterior interosseous nerve or the superficial radial branch in four cases and the common digital nerves in two cases. There was a concomitant involvement of the median and ulnar nerves in two other patients. Clinically, there were eight different compression neuropathies, of which the most frequent was the carpal tunnel syndrome. The postoperative histology was consistent with preoperative magnetic resonance imaging findings in the vascular and fatty tumours. Pain disappeared completely in 15 out of 16 patients with preoperative pain. All patients had preoperative paraesthesia, which persisted after tumour excision in three patients: attenuated in two patients and unchanged in one. In three patients, we did not observe any change in paresis or amyotrophy. The mean postoperative follow-up was 31 months, without tumour recurrence. The quick Disabilities of the Arm, Shoulder and Hand (DASH) score went from 49.9 points preoperatively to 10.2 points after surgery.
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PMID:Nerve compression syndromes of the hand and forearm associated with tumours of non-neural origin and tumour-like lesions. 2459 40

Carpal tunnel syndrome represents compression of the median nerve in the carpal tunnel, which is defined by the carpal bones on the lateral, medial, and dorsal aspects and the transverse carpal ligament on the anterior aspect.1 Symptoms of carpal tunnel syndrome include paresthesia, anesthesia, paresis, and pain located in the median nerve distribution. In severe cases, there may be atrophy of median nerve-innervated thenar muscles. In the United States, carpal tunnel syndrome affects approximately 3.72% of the population.2 Conservative measures, such as bracing, steroid injections, and physical and occupational therapy, are commonly employed.1 However, many patients still require more definitive surgical management, which may be in the form of open or endoscopic procedures. Regardless of surgical approach, the clinical success rates of carpal tunnel release have been reported to be 75%-90%.3 Recurrence rates are 8.4%-15% over 4-5 years,4,5 with the lower end of this range representing the Agee single-portal technique. Endoscopic carpal tunnel release leads to reduced postoperative pain and an increase in transient neurologic deficits; however, no improvements have been reported in overall complication rate, subjective satisfaction, return to work, postoperative grip and pinch strength, and operative time.6 In this technical video, we present a case of single-incision endoscopic carpal tunnel release in a patient with severe symptoms after conservative measures failed. The patient experienced a noncomplicated postoperative course and demonstrated an excellent recovery at follow-up visits. Surgical decompression is an important treatment for refractory carpal tunnel syndrome, and videos such as this provide guidance for safe and effective treatment (Video 1).
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PMID:Endoscopic Carpal Tunnel Release. 3234 93