Peripheral Nerve Disorders

2021 ◽  
pp. 760-771
Author(s):  
Sarah E. Berini ◽  
Nathan P. Staff
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Family History ◽  
Peripheral Nerve ◽  
Time Course ◽  
Large Diameter ◽  
Sensory Loss ◽  
Careful Attention ◽  
Neurologic Examination ◽  
Muscle Stretch

Disorders of the peripheral nerves are some of the most common conditions that neurologists face in clinical practice. The wide differential diagnosis that often accompanies peripheral nerve disorders may be narrowed by careful attention to the history (time course, severity, preexisting disease, and family history); peripheral neuroanatomy; patient symptomatology (sensory loss, paresthesia, pain, and weakness); and neurologic examination (sensory loss, weakness, atrophy, and reduced muscle stretch reflexes). Electromyography is used to assess large-diameter myelinated axons (touch, pressure, vibration, proprioception, and motor) and aid in localization by helping to narrow the differential diagnosis and predict axonal or demyelinating pathophysiology.

POST-TRANSFUSION PURPURA VS. HEPARIN-INDUCED THROMBOCYTOPENIA: DIFFERENTIAL DIAGNOSIS IN CLINICAL PRACTICE

2000 ◽  
Vol 10 (4) ◽  
pp. 323-324 ◽  
Author(s):  
F. Araujo ◽  
J. J. Sa ◽  
V. Araujo ◽  
M. Lopes ◽  
L. M. Cunha-Ribeiro
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Heparin Induced Thrombocytopenia

Evaluating Shoulder Impairment

1998 ◽  
Vol 3 (5) ◽  
pp. 1-3
Author(s):  
Richard T. Katz ◽  
Sankar Perraraju
Keyword(s):  
Peripheral Nerve ◽  
Upper Extremity ◽  
Sensory Loss ◽  
Motor Deficits ◽  
Nerve Lesion ◽  
Fourth Edition ◽  
Specific Patient ◽  
Industrial Medicine ◽  
Shoulder Motion ◽  
Upper Extremity Impairment

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, offers several categories to describe impairment in the shoulder, including shoulder amputation, abnormal shoulder motion, peripheral nerve disorders, subluxation/dislocation, and joint arthroplasty. This article clarifies appropriate methods for rating shoulder impairment in a specific patient, particularly with reference to the AMA Guides, Section 3.1j, Shoulder, Section 3.1k, Impairment of the Upper Extremity Due to Peripheral Nerve Disorders, and Section 3.1m, Impairment Due to Other Disorders of the Upper Extremity. A table shows shoulder motions and associated degrees of motion and can be used in assessing abnormal range of motion. Assessments of shoulder impairment due to peripheral nerve lesion also requires assessment of sensory loss (or presence of nerve pain) or motor deficits, and these may be categorized to the level of the spinal nerves (C5 to T1). Table 23 is useful regarding impairment from persistent joint subluxation or dislocation, and Table 27 can be helpful in assessing impairment of the upper extremity after arthroplasty of specific bones of joints. Although inter-rater reliability has been reasonably good, the validity of the upper extremity impairment rating has been questioned, and further research in industrial medicine and physical disability is required.

scholarly journals Malignant Peripheral Nerve Sheath Tumor in the Nasal Cavity of a Neonate: A Case Report

2021 ◽  
pp. 014556132110141
Author(s):  
Xiufang Chi ◽  
Yue Wang ◽  
Haoming Yang ◽  
Cheng Xing ◽  
Jiamin Gan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Peripheral Nerve ◽  
Nasal Cavity ◽  
Nerve Fibers ◽  
Nerve Sheath Tumor ◽  
Rare Tumor ◽  
Nasal Mass ◽  
Peripheral Nerve Sheath Tumor ◽  
Related Literature ◽  
Nerve Sheath

Malignant peripheral nerve sheath tumor (MPNST) is a rare tumor that can develop on the lining of nerves and within the network of nerve fibers in different organs, and it is commonly found in the head and neck, limbs, and trunk. These tumors can occur in patients of any age. They most commonly occur in adults aged 20 to 50 years; however, fewer cases of this tumor in children have been reported. To date, no neonatal case of MPNST in the nasal cavity has been reported. Here, we report the case of a 4-day-old female newborn who presented with a nasal mass that re-enlarged after surgery and was diagnosed as MPNST of the nasal cavity on the basis of pathological results. This is the first report of MPNST in the nasal cavity of a neonate. Differential diagnosis and treatment of nasal masses have been proposed in the related literature.

Venous Thromboembolism: Genetics and Thrombophilias

2021 ◽  
Vol 42 (02) ◽  
pp. 271-283
Author(s):  
Manila Gaddh ◽  
Rachel P. Rosovsky
Keyword(s):  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Family History ◽  
Morbidity And Mortality ◽  
Inherited Thrombophilia ◽  
Risks And Benefits ◽  
Hereditary Thrombophilia ◽  
The World ◽  
The Future ◽  
History Of

AbstractVenous thromboembolism (VTE) is a major cause of morbidity and mortality throughout the world. Up to one half of patients who present with VTE will have an underlying thrombophilic defect. This knowledge has led to a widespread practice of testing for such defects in patients who develop VTE. However, identifying a hereditary thrombophilia by itself does not necessarily change outcomes or dictate therapy. Furthermore, family history of VTE by itself can increase an asymptomatic person's VTE risk several-fold, independent of detecting a known inherited thrombophilia. In this article, we will describe the current validated hereditary thrombophilias including their history, prevalence, and association with VTE. With a focus on evaluating both risks and benefits of testing, we will also explore the controversies of why, who, and when to test as well as discuss contemporary societal guidelines. Lastly, we will share how these tests have been integrated into clinical practice and how to best utilize them in the future.

scholarly journals A comparison of two-dimensional and three-dimensional techniques for determining the kinematic patterns for hindlimb obstacle clearance during sheep locomotion.

2020 ◽  
Author(s):  
Camila Cardoso Diogo ◽  
Bárbara Fonseca ◽  
Francisca S.M. Almeida ◽  
Luís Maltez da Costa ◽  
José Eduardo Pereira ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Time Course ◽  
Objective Assessment ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Ovine Model ◽  
Obstacle Clearance ◽  
Injury And Repair

Abstract Background: Analysis of locomotion is often used as a measure for impairment and recovery following experimental peripheral nerve injury. Compared to rodents, sheep offer several attractive features as an experimental model for studying peripheral nerve regeneration. There are no studies on locomotion outcomes after peripheral nerve injury and repair in the sheep model. In the present study, we performed and compared two-dimensional (2D) and, for the first time, three-dimensional (3D) hindlimb kinematics during obstacle avoidance in the ovine model. This study aimed to obtain kinematic data to serve as a template for an objective assessment of the ankle joint motion in future studies of common peroneal nerve (CP) injury and repair in the ovine model. Results: The strategy used by the sheep to bring the hindlimb over a moderately high obstacle, set to 10% of its hindlimb length, was the pronounced knee, ankle and metatarsophalangeal flexion when approaching and clearing the obstacle. Despite the overall time course kinematic patterns about the hip, knee, ankle, and metatarsophalangeal were identical, we found significant differences between values of the 2D and 3D joint angular motion. Conclusions: Our results show that the most apparent changes that occurred during the gait cycle were for the ankle and metatarsophalangeal joints, whereas the hip and knee joints were much less affected. Data and techniques described here are likely to be useful for an objective assessment of altered gait after CP injury and repair in an ovine model.

scholarly journals Cardiac Outpouchings: Definitions, Differential Diagnosis, and Therapeutic Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Riccardo Scagliola ◽  
Gian Marco Rosa ◽  
Sara Seitun
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Therapeutic Approach ◽  
Tissue Characterization ◽  
Case Reports ◽  
Case Series ◽  
Diagnostic Challenge ◽  
Comprehensive Overview ◽  
Search Data ◽  
Data Location

Background and Aims. Cardiac outpouchings encounter a series of distinct congenital or acquired entities (i.e. aneurysms, pseudoaneurysms, diverticula, and herniations), whose knowledge is still poorly widespread in clinical practice. This review aims to provide a comprehensive overview focusing on definition, differential diagnosis, and prognostic outcomes of cardiac outpouchings, as well as further insights on therapeutic options, in order to assist physicians in the most appropriate decision-making. Methods. The material reviewed was obtained by the following search engines: MEDLINE (PubMed), EMBASE, Google Scholar, and Clinical Trials databases, from January 1966 until March 2021. We searched for the following keywords (in title and/or abstract): (“cardiac” OR “heart”) AND (“outpouching” OR “outpouch” OR “aneurysm” OR “pseudoaneurysm” OR “false aneurysm” OR “diverticulum” OR “herniation”). Review articles, original articles, case series, and case reports with literature review were included in our search. Data from patients with congenital or acquired cardiac outpouchings, from prenatal to geriatric age range, were investigated. Results. Out of the 378 papers initially retrieved, 165 duplicates and 84 records in languages other than English were removed. Among the 129 remaining articles, 76 were included in our research material, on the basis of the following inclusion criteria: (a) papers pertaining to the research topic; (b) peer-reviewed articles; (c) using standardized diagnostic criteria; and (d) reporting raw prevalence data. Location, morphologic features, wall motion abnormalities, and tissue characterization were found to have a significant impact in recognition and differential diagnosis of cardiac outpouchings as well as to play a significant role in defining their natural history and prognostic outcomes. Conclusions. Careful recognition of cardiac outpouchings remains a diagnostic challenge in clinical practice. Due to a broad cluster of distinctive and heterogeneous entities, their knowledge and timely recognition play a pivotal role in order to provide the most appropriate clinical management and therapeutic approach.

scholarly journals Tremorography in the clinical practice

2020 ◽  
Vol 9 (4) ◽  
pp. 61-72
Author(s):  
T. G. Govorova ◽  
T. E. Popova ◽  
A. A. Tappakhov
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Movement Disorders ◽  
Clinical Characteristics ◽  
Objective Assessment ◽  
Diagnostic Value ◽  
Common Type ◽  
Routine Practice ◽  
Pathological Tremor

Tremor is the most common type of movement disorders. In practice this differential diagnosis of hyperkinesis is diagnosed clinically and the use of additional methods of objective assessment of tremor increases the accuracy of diagnosis. The use of paraclinical methods of objective assessment of tremor improves the accuracy of diagnosis. Comparison of the neurophysiological parameters of tremor with clinical characteristics has a high diagnostic value, which justifies its use in the routine practice of neurologists. The purpose of the review is to analysis basic electrophysiological characteristics of pathological tremor, as well as the presentation of the material of its own observation.

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