Neurological

2019 ◽  
pp. 109-186
Author(s):  
Tanya M. Monaghan ◽  
James D. Thomas
Keyword(s):  
Nerve Palsy ◽  
Cauda Equina ◽  
Radial Nerve Palsy ◽  
Pseudobulbar Palsy ◽  
Subacute Combined Degeneration ◽  
Charcot Marie Tooth Disease ◽  
Tabes Dorsalis ◽  
Median Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Muscles Of The Hand

This chapter concerns neurological medicine, and covers dermatomes, peripheral nerves and tendon reflexes, peripheral neuropathy, hemiplegia, myotonic dystrophy, proximal myopathy, motor neurone disease, cerebellar syndrome, myasthenia gravis, cervical myelopathy, median nerve palsy, ulnar nerve palsy, radial nerve palsy, wasting of the small muscles of the hand, syringomyelia, polymyositis, Parkinson’s disease, Friedreich’s ataxia, Charcot–Marie–Tooth disease, subacute combined degeneration of the cord, tabes dorsalis, cerebellopontine angle syndrome, paraplegia, visual field defect, nerve palsy, nystagmus, Horner’s syndrome, ptosis, large pupil, small pupil, Holmes–Adie–Moore syndrome, Argyll Robertson pupil, internuclear ophthalmoplegia, facial palsy, bulbar palsy, pseudobulbar palsy, and cauda equina syndrome.

scholarly journals Closed pinning for paediatric supracondylar fractures: does timing really matter?

2017 ◽  
Vol 3 (3) ◽  
pp. 417
Author(s):  
Suresh Babu Surapaneni ◽  
Ravi Kiran Kopuri ◽  
Venkata Suresh Babu Tummala
Keyword(s):  
Closed Reduction ◽  
Nerve Palsy ◽  
Radial Nerve Palsy ◽  
Radial Pulse ◽  
Supracondylar Fractures ◽  
Average Delay ◽  
Median Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Pin Fixation ◽  
Group 2

<p><strong>Background:</strong> Management guidelines and comparative studies are not yet clear for those patients who present early and late with widely displaced supracondyle humerus fracture in children.</p><p><strong>Methods:</strong> A total of 74 children were included in this study, 30 patients presenting early within 24 hours as group 1, and 44 patients who presented late i.e. after 24 hours and within a week as group 2 underwent closed reduction and pinning.<strong></strong></p><p><strong>Results: </strong>In group one 24 had excellent, 6 had good results, according to modified Flynn’s criteria. One patient developed ulnar nerve palsy which was iatrogenic, and improved completely after wire removal. Another was brachial artery injury which was explored and recovered completely. In group 2 the average delay in presentation was 57.56 hours; mean time to surgery after presentation was 9.83 hours. Sixteen patients (36.36%) had neurologic complications at presentation to the emergency room of which three had median nerve palsy (6.81%) whereas seven (15.90%) had isolated anterior interosseous nerve palsy and six (13.6%) had radial nerve palsy all patients showed total neurological recovery at 12 weeks. Six patients (13.63%) had vascular compromise at initial presentation of which five patients had feeble radial pulse and one had absent radial pulse, but capillary filling was adequate in all. The pulse was restored within 24 hours in all patients following reduction. There were 37 excellent, 6 good and 1fair results.</p><p><strong>Conclusions:</strong> Our results support, closed reduction and Percutaneous pin fixation as an effective treatment option for grossly displaced supracondylar fractures presenting early and late but requires good and careful judgment and also technique.</p>

SPLINTING FOR PERIPHERAL NERVE INJURY IN UPPER LIMB

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 251-259 ◽  
Author(s):  
Rebecca K. Y. Chan
Keyword(s):  
Peripheral Nerve ◽  
Nerve Palsy ◽  
Injury Severity ◽  
Nerve Repair ◽  
Hand Function ◽  
Radial Nerve Palsy ◽  
Joint Contractures ◽  
Median Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Severity Of Injury

The prognosis and speed of peripheral nerve recovery depend very much on the level of injury, severity of injury, the surgical intervention and the subsequent rehabilitative process. Many high level injuries may take years or months for the affected peripheral nerve to recover. Prolonged muscle imbalance causes joint contractures and over-stretching of denervated muscles. Without proper care, hand function recovery may be limited even the nerve regenerated afterwards. During the nerve regeneration period, splinting is one of the most useful modality to minimise deformities, prevent joint contractures and substitute loss motor control. Proper splinting encourages early use of the injured hand in daily activities. There are different types of splinting design for median nerve palsy, ulnar nerve palsy and radial nerve palsy. Dynamic splinting techniques are frequently employed to allow early prehension activities. Other therapeutic techniques, including pressure garment and sensory re-education are useful to enhance better functional return after nerve repair.

scholarly journals SUPRA CONDYLAR FRACTURE OF THE HUMERUS IN CHILDREN;

2013 ◽  
Vol 20 (03) ◽  
pp. 456-461
Author(s):  
MOGHEES IKRAM AMEEN ◽  
AQEEL SAFDAR ◽  
FAUZIA MOGHEES
Keyword(s):  
Nerve Palsy ◽  
Neurological Complications ◽  
Late Presentation ◽  
Radial Nerve Palsy ◽  
X Rays ◽  
Supracondylar Fractures ◽  
Post Injury ◽  
Type Iii ◽  
Fractures In Children ◽  
Median Nerve Palsy

Supra condylar fractures in children are a serious injury with a significant morbidity. Setting: CMH Multan. Patients presentvery late, often after being mishandled by traditional bone-setters, with lifelong consequences. All children up to the age of 12 years withsupra condylar humeral fractures presenting to our hospital were included in the study. Careful history and examination was carried outand necessary x-rays were taken. Time since injury, all treatments administered, complications and any other data was recorded. Period:From 1999 to 2004. 304 cases were included in the study. Only 12% patients presented within 24 hours. 87.5% children presented from72 hours to 3 weeks post injury. The reasons recorded were lack of access to proper medical help, illiteracy, poverty and manipulation bytraditional bone setters. Based on Gartland's Classification1 61% patients had un-displaced and 39% had displaced fractures. 61% wereType I fractures, 19% Type II and 20% Type III fractures. Due to late presentation these patients had more complications including myositisossificans, neurological complications and contractures due to tight bandages by traditional health bone setters. Patients with displacedsupracondylar fractures, who present early, usually require manipulation and fixation by percutaneous pinning 2,3,4. In our study,because of very late presentation they could not be treated by closed reduction and 18 %cases with type III fractures were treated by OpenReduction and Internal Fixation. Since they presented very late and had complications like Radial nerve palsy, Median nerve palsy, Ulnar5 nerve palsy , ischemia, Brachial artery compression, Compartment syndrome, Volkmann's ischemic contracture the treatment protocolhad to be changed. Post operative complications in a few patients included Pin tract infection and Elbow stiffness. In most cases full rangeof movement could not be achieved, however functional movement was satisfactory. These resulted in less patient satisfaction andlifelong consequences. To conclude our study shows that due to very late presentation of supracondylar fractures of the humerus inchildren different management protocols have to be made, tailored to individual needs of the patient.

Reconstruction after nerve injury

2011 ◽  
Author(s):  
T.E.J. Hems
Keyword(s):  
Nerve Injury ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Common Type ◽  
Radial Nerve Palsy ◽  
Reconstructive Procedures ◽  
Tendon Transfers ◽  
Ulnar Nerve Palsy ◽  
Intrinsic Paralysis ◽  
Median Nerve Injury

♦ Late reconstructive procedures may improve function if there is persisting paralysis after nerve injury♦ Transfer of a functioning musculotendinous unit to the tendon of the paralysed muscle is the most common type of procedure♦ Passive mobility must be maintained in affected joints before tendon transfer can be performed♦ The transferred muscle should be expendable, have normal power, and have properties appropriate to the function it is required to restore♦ Tendon transfers can provide reliable improvement in function after isolated radial nerve palsy♦ A number of procedures have been described for reconstruction of thumb opposition but impaired sensation after median nerve injury may limit gain in function♦ Tendon transfers are possible to improve clawing of fingers and lateral pinch of the thumb after ulnar nerve palsy or other cases of intrinsic paralysis.

scholarly journals Arm-wrestling injuries – A systematic review of the medical literature

2020 ◽  
pp. 1-3
Author(s):  
Renan Felipe Correia ◽  
Alex Natalino Ribeiro ◽  
Roberto Pires de Araújo
Keyword(s):  
Systematic Review ◽  
Popular Culture ◽  
Nerve Palsy ◽  
Medical Literature ◽  
Case Reports ◽  
Medial Epicondyle ◽  
Radial Nerve Palsy ◽  
Ulnar Nerve Palsy ◽  
Correct Technique ◽  
Practice Methods

Background: Arm wrestling is a popular sport due to its simplistic nature and great appeal in popular culture. Unfortunately, it can lead to serious fractures. An understanding of these injuries and its mechanisms is vital to the undertaking of safe practice methods for this sporting modality. Objectives: This study aimed to review articles that demonstrate case reports about arm-wrestling related fractures. Methods: PubMed’s database was searched with the keywords “Arm Wrestling,” Arm-wrestling,” and “Armwrestling.” Ofthe 34 articles found, 11 were fit to compose this review, being grouped into studies that dealt with adults and studies that dealt with adolescents. Results: Of the 63 adult subjects reported, 62 suffered fractures of the distal third of the humerus, occasionally accompanied by butterfly fractures and radial nerve palsy. Of the 22 adolescent subjects reported, 20 suffered fractures of the humerus medial epicondyle, never accompanied by butterfly fractures, and sometimes accompanied by ulnar nerve palsy. All injuries stemmed from unbalanced torsional forces suffered by the humerus from its own musculature. Conclusions: The injury profile presented by both populations is very homogeneous between the two different groups, which leads us to believe that correct technique can be a great ally in arm wrestling injury prevention. Athletes, as well as common practitioners, should be coached as to avoid these unfavorable positions and techniques

Combined ulnar nerve palsy in Guyon's canal and distal median nerve irritation following excessive canoeing

2006 ◽  
Vol 37 (01) ◽  
Author(s):  
F Paul ◽  
F Paul ◽  
FJ Dieste ◽  
T Ratzlaff ◽  
HP Vogel ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Guyon’S Canal ◽  
Ulnar Nerve Palsy ◽  
Guyon's Canal

Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function

Hand ◽  
2021 ◽  
pp. 155894472098812
Author(s):  
J. Megan M. Patterson ◽  
Stephanie A. Russo ◽  
Madi El-Haj ◽  
Christine B. Novak ◽  
Susan E. Mackinnon
Keyword(s):  
Radial Nerve ◽  
Tendon Transfer ◽  
Nerve Palsy ◽  
Nerve Transfer ◽  
Pinch Strength ◽  
Radial Nerve Palsy ◽  
Nerve Injuries ◽  
Tendon Transfers ◽  
Nerve Transfers ◽  
Transfer Group

Background: Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries. Methods: A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups. Results: For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups. Conclusions: The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.

scholarly journals A Very Rare Case of Hypertrophic Neuropathy with Left Ulnar Nerve Palsy

1984 ◽  
Vol 32 (4) ◽  
pp. 1195-1198
Author(s):  
A. Kawano ◽  
M. Kido ◽  
K. Shibata ◽  
A. Ohnishi ◽  
T. Mitsuyasu
Keyword(s):  
Ulnar Nerve ◽  
Rare Case ◽  
Nerve Palsy ◽  
Hypertrophic Neuropathy ◽  
Ulnar Nerve Palsy
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