6/22/2023 0 Comments Nerve compression syndrome![]() EtiologyĪ multifactorial origin is considered in which the occurrence of an acute or chronic repetitive stress due to fixed or dynamic compressive forces are important factors 6. Nerve compression syndromes often develop at specific sites, where nerves travel through narrow anatomical openings such as fibrous, fibro-osseous or muscular tunnels and rub at tight edges or get compressed during motion. The majority of peripheral nerve compression injuries can be classified as grade 1 nerve injuries or neuropraxia and are characterized by focal demyelination at the compression site without associated axonal or connective tissue damage 5,6. This can result in structural alterations such as fibrosis, focal or segmental demyelination, degeneration and inflammatory changes of the myelin sheath and possibly the nerve axons at the site of compression further leading to alterations in axonal transport and decreased mechanosensitivity 3,4. If left untreated nerve compression syndromes can lead to axonal Wallerian degeneration and permanent fibrotic changes with functional loss, muscular atrophy and fatty degeneration.Īcute injury or chronic repetitive trauma and compression are thought to cause edema and microvascular ischemic changes of the myelin sheath 3,4. Some nerve entrapment syndromes will predominantly or only feature either motor or sensory symptoms. In major mixed nerves, symptoms might also include dry skin, cracked nails and recurrent skin ulcerations. Clinical testing might include altered reflexes or sensory testing including decreased mechanosensitivity 3. Symptoms of nerve entrapment syndromes will mostly depend on the location and the nerve involved and generally include pain, paresthesia numbness, muscular weakness and atrophy in specific distribution territory of the affected nerve. A local nerve block by injecting a local anesthetic can also confirm the diagnosis. Electrodiagnostic tests as nerve conduction studies and electromyography can help to confirm the clinical diagnosis 4. ![]() The diagnosis of most nerve entrapment neuropathies can be made on clinical grounds. Predisposing factors that increase the risk of nerve compression syndromes include the following 3: mass occupying lesions ( cysts, tumors).Nerve compression syndromes are associated with the following conditions 2: The most common nerve entrapment neuropathy is carpal tunnel syndrome 1-3 followed by cubital tunnel syndrome 1. Nerve compression syndromes are common 1-5 and can account for 10-20% of cases in specialist clinics of neurosurgeons, orthopedic and plastic surgeons treating those cases.
0 Comments
Leave a Reply. |