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SYMPOSIUM: ENTRAPMENT NEUROPATHIES. Clinical basis of entrapment neuropathies

Dariusz J. Jaskólski

Affiliation and address for correspondence
Aktualn Neurol 2006, 6 (4), p. 232-241
Abstract

Peripheral nerve entrapment is a condition of chronic injury of a nerve passing through a narrow, noncompliant anatomical canal. This leads to clinically apparent entrapment neuropathy with pain and paresthesias in distribution of the affected nerve, progressing to motor weakness and muscle atrophy. The most common peripheral nerve entrapment is carpal tunnel syndrome found in 0.5 to 3% of the population. In the US, patients with entrapment neuropathies make up 10 to 20% of all neurosurgical cases. Deformities resulting from bone fractures or arthritis may account for chronic nerve compression as found in the classic tardy ulnar palsy. Not unusually, nerves are compressed by atypical anatomical structures such as Struthers ligament (median nerve), arcades of Struthers (ulnar nerve) or arcade of Fröhse (radial nerve). Superficially located nerves are vulnerable to direct trauma during the routine daily activities as this is the case with the ulnar nerve at the elbow and with the superficial lateral femoral nerve in patients wearing tight jeans. Entrapment neuropathies are frequently associated with pregnancy and acromegaly, with metabolic disorders (diabetes mellitus, alcoholism, chronic hemodialyses) and with hereditary neuropathy with liability to pressure palsies (HNPP), the condition showing autosomal dominant inheritance and caused by the deletion of a segment of chromosome 17p11.2-12 which contains peripheral myelin protein-22 gene (PMP22). Following general considerations, the clinical symptoms and etiology of carpal tunnel syndrome, pronator teres syndrome, anterior interosseous nerve syndrome, entrapment of the ulnar nerve at the elbow and at the wrist and hand, posterior interosseous nerve syndrome, Wartenberg syndrome, thoracic outlet syndrome, entrapment of the suprascapular and musculocutaneous nerves, Roth syndrome, tarsal and anterior tarsal tunnel syndromes, neuropathies of peroneal nerves and saphenous nerve as well as Morton’s neuroma were reviewed in detail. 

Keywords
epidemiology, etiology, symptomatology of entrapment neuropathies, entrapment neuropathies of the median nerve, the ulnar nerve, the radial nerve, thoracic outlet syndrome, entrapment neuropathies of the lower extremity

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