COMPRESSIVE NEUROPATHIES RELATED TO GANGLIONS OF THE WRIST AND HAND

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 113-116 ◽  
Author(s):  
Prakash Jayakumar ◽  
Vijay Jayaram ◽  
David S. Nairn
Keyword(s):  
Surgical Treatment ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Clinical Assessment ◽  
Guyon’S Canal ◽  
Unique Case ◽  
Sensory Deficits ◽  
Compressive Neuropathy ◽  
Guyon's Canal

Ganglions of the wrist and hand causing compressive neuropathies are rare clinical entities. Compression of the ulnar and median nerves in their respective fibro-osseous tunnels lead to characteristic patterns of motor and/or sensory deficits, which are directly related to the location of the lesion. We present a unique case of a "dumbbell" shaped ganglion invading both Guyon's canal and the carpal tunnel causing a dual compressive neuropathy of the ulnar and median nerve. We discuss the patho-anatomy, clinical assessment, investigation and surgical treatment of this condition.

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

Ulnar and Median Nerve Abnormalities in Carpal Tunnel Syndrome

2020 ◽  
Vol 22 (5) ◽  
pp. 313-322
Author(s):  
Filip Georgiew ◽  
Andrzej Maciejczak ◽  
Jakub Florek ◽  
Ireneusz Kotela
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Control Group ◽  
Conduction Disturbances ◽  
Tunnel Syndrome ◽  
Sensory Fibers ◽  
American Academy Of Neurology

Background. Nerve compression underlying carpal tunnel syndrome (CTS) results in an increase in the threshold of superficial sensation in the area supplied by the median nerve, which is a mixed nerve dominated by sensory fibres. The distribution of sensory symptoms is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment at wrist level is still unclear. Patho­logical processes leading to median neuropathy in CTS may affect ulnar nerve motor and sensory fibers in the Guyon canal. This may explain the extra-median spread of sensory symptoms in CTS patients. Material and methods. The study involved 88 patients (104 hands), with 70 women (83 hands) and 18 men (21 hands) aged between 25 and 77 years. 50 age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. The diagnosis of carpal tunnel syndrome was made according to the criteria of the American Academy of Neurology 1993 guidelines. Based on the results of an ENG trace evaluating the degree of conduction disturbances in the median nerve, the patients were classified to one of three severity subgroups. The threshold of sensory excitability to pulsed current was determined in a test with single 100 ms rectangular pulses. Conclusions. 1. The threshold of sensation in the fingers innervated by the median and ulnar nerve is significantly lon­ger in patients with CTS than in controls. 2. Surgical treatment decreases the threshold of sensation in the fingers innervated by the median nerve. 3. Surgical treatment does not decrease the threshold of sensation in the fingers innervated by the ul­nar nerve. 4. The preoperative and postoperative threshold of sensation in the fingers innervated by the median and ulnar nerve is significantly longer in patients with severe carpal tunnel than in mild and moderate cases.

Selective Motor Neuropathy of the Median Nerve Caused by a Ganglion in the Carpal Tunnel

1998 ◽  
Vol 23 (5) ◽  
pp. 611-612 ◽  
Author(s):  
B. CROWLEY ◽  
C. R. GSCHWIND ◽  
C. STOREY
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Motor Dysfunction ◽  
Motor Neuropathy ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome

Carpal tunnel syndrome is the commonest peripheral compressive neuropathy. Typically, sensory symptoms predominate at presentation with motor dysfunction seen in more chronic cases. Isolated motor compression is rare. We present a case of selective median nerve motor neuropathy caused by a carpal tunnel ganglion.

scholarly journals Carpal tunnel syndrome: assessment of the need for rehabilitation and recovery treatment after endoscopic decompression of the median nerve in the late and long-term postoperative periods

2020 ◽  
Vol 9 (4) ◽  
pp. 34-43
Author(s):  
D. G. Yusupova ◽  
A. A. Zimin ◽  
D. A. Grishina ◽  
N. V. Belova ◽  
A. V. Vershinin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Controlled Study ◽  
Control Group ◽  
Clear Understanding ◽  
Significant Difference ◽  
Tunnel Syndrome

Background. Carpal tunnel syndrome is the most common tunnel neuropathy in which the median nerve is compressed at the level of the wrist in the carpal canal. Treatment of carpal tunnel syndrome can be conservative and surgical. Surgical treatment is indicated in case of ineffective conservative treatment. However, the strategy of managing patients with carpal tunnel syndrome in the postoperative period has not yet been determined; there is no clear understanding of the effectiveness and necessity of rehabilitation in the early and long-term postoperative periods.Aim. Follow-up the patients after decompression of the median nerve in the late (up to 3 weeks after surgery) and long-term (3 weeks after surgery) postoperative periods to assess the effectiveness of different methods of rehabilitation.Materials and methods. A randomized controlled study included 108 cases of idiopathic carpal tunnel syndrome (unilateral and bilateral). After surgery, the patients were divided into three groups: the restorative treatment group using magnetic therapy, the kinesiotherapy group, and the control group. Clinical, neurophysiological and ultrasound monitoring was carried out for six months.Results. Patients of all the groups showed similar improvement in the most of the analyzed parameters, without any significant difference.Conclusion. Thus, according to the results of a comprehensive study, it is evident that early diagnosis of carpal tunnel syndrome and a high-quality surgical decompression of the median nerve with a complete dissection of the flexor retinaculum of the hand guarantee improvement within six months or later after surgical treatment without additional rehabilitation measures.

Nesteroidic Antiinflammators with Variable Chemical Structure that Prevent Anti-inflammatory Effect in the Carpal Tunnel Syndrome - Compressive Neuropaty of the Median Nerve

2018 ◽  
Vol 69 (7) ◽  
pp. 1779-1784
Author(s):  
Alice Arina Ciocan Pendefunda ◽  
Razvan Leata ◽  
Vasile Nicolae ◽  
Codrina Ancuta ◽  
Adriana Elena Craciun ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Moderate Intensity ◽  
Distribution Area ◽  
Posterior Aspect ◽  
Compressive Neuropathy ◽  
Gradual Process ◽  
Dental Practitioners ◽  
Tunnel Syndrome

Musculoskeletal pathology reaches important proportions in dental practitioners. Besides the articular manifestations of inflammatory or degenerative rheumatism, in daily practice we often find patients suffering from abarticular pathological processes, during which tendons, synovial dysplasia, schizophrenia, fascia, aponevrozes are affected. The Carpal Tunnel Syndrome represents a compressive neuropathy of the median nerve inside the carpal tunnel of the wrist. Any condition that lowers the dimensions of the carpal tunnel can cause symptoms of carpal tunnel syndrome. The carpal channel (Carpal Tunnel) is divided by a sagittal fibrous divider into two osteofibrosis osteofibrosis: medial and lateral. This blade separates from the posterior aspect of the flexor retina and is inserted into the carpal bones (scaffold, trapezoid and capita). This syndrome has received particular attention in recent years due to the fact that it can occur in people whose work involves repetitive hand activities. Repeated use of the hand, repetition of the same movements and activities of the hand and wrist, over a long period of time, can cause inflammation of the tendons in the wrist, causing swelling, which puts pressure on the nerve. Symptoms of Carpal Tunnel Syndrome begin gradually - without specific trauma. It is a gradual process for most people, carpal tunnel syndrome is aggravated over time without appropriate treatment. The study includes a batch of 75 dentists from Galati County, selected following the application of the inclusion criteria referring to the presence of signs and symptoms characterizing carpal tunnel syndrome in 2015-2017. Sensitivity disorders and paraesthesias accompanying nerve suffering are symptoms that create discomfort and contributes to the deterioration of pretension and force so useful to the professional act of dental medicine. Perceived cramping pain, often of moderate intensity, located at the fist and distal in the distribution area of the median nerve, rarely the pains are intense and radiate upward along upper limb to shoulder.

The History of Carpal Tunnel Syndrome

1988 ◽  
Vol 13 (1) ◽  
pp. 28-34
Author(s):  
G. B. PFEFFER ◽  
R. H. GELBERMAN ◽  
J. H. BOYES ◽  
B. RYDEVIK
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Transverse Carpal Ligament ◽  
Motor Branch ◽  
Compressive Neuropathy ◽  
Anatomical Localization ◽  
History Of ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome

Carpal tunnel syndrome is the most frequently diagnosed, best understood and most easily treated entrapment neuropathy. During the first half of the 20th century, however, most patients with carpal tunnel syndrome were diagnosed as having compression of either the brachial plexus or thenar nerve motor branch of the median nerve. As late as 1950, only twelve patients with operative release of the transverse carpal ligament for idiopathic carpal tunnel syndrome had been reported. The delay in accurate anatomical localization of this compressive neuropathy can be attributed both to the confusion caused by the diverse manifestations of median nerve compression in the carpal tunnel, and to some interesting developments that altered early investigations in this area.

Ultrasonographic and functional changes of the ulnar nerve at Guyon’s canal after carpal tunnel release

2010 ◽  
Vol 121 (2) ◽  
pp. 208-213 ◽  
Author(s):  
F. Ginanneschi ◽  
G. Filippou ◽  
F. Reale ◽  
C. Scarselli ◽  
M. Galeazzi ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Guyon’S Canal ◽  
Functional Changes ◽  
Guyon's Canal

Pre- and Postoperative Guyon’s Canal Pressure Change in Endoscopic Carpal Tunnel Release: Correlation with Transient Postoperative Guyon’s Canal Syndrome

2009 ◽  
Vol 34 (2) ◽  
pp. 208-211 ◽  
Author(s):  
I. OKUTSU ◽  
I. HAMANAKA ◽  
A. YOSHIDA
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pressure Change ◽  
Active Power ◽  
Guyon’S Canal ◽  
Pneumatic Tourniquet ◽  
Endoscopic Carpal Tunnel Release ◽  
Carpal Tunnel Release Surgery ◽  
Guyon's Canal ◽  
Canal Syndrome

Perioperative Guyon’s canal and carpal canal pressure in one-forearm portal endoscopic carpal tunnel release surgery were measured in resting position and during active power gripping in 66 hands. This was done using the continuous infusion technique with a local anaesthetic and without pneumatic tourniquet. Immediate mean postoperative Guyon’s canal and carpal canal pressure decreased in both measurements. During active power gripping, postoperative Guyon’s canal pressure was less than 40 mmHg in 61 hands, however, this increased to over 40 mmHg in five hands. In these five hands, Guyon’s canal syndrome did not develop. Guyon’s canal and carpal canal pressures were only correlated during postoperative active power gripping. It remains unclear whether immediate postoperative Guyon’s canal pressure correlates with higher pressures a few days later as reported in cases of transient postoperative Guyon’s canal syndrome.

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