scholarly journals Efficacy of 5% Dextrose Water Injection for Peripheral Entrapment Neuropathy: A Narrative Review

2021 ◽  
Vol 22 (22) ◽  
pp. 12358
Author(s):  
Yung-Tsan Wu ◽  
Chueh-Hung Wu ◽  
Jui-An Lin ◽  
Daniel Su ◽  
Chen-Yu Hung ◽  
...  
Keyword(s):  
Water Injection ◽  
Local Treatment ◽  
Treatment Method ◽  
Narrative Review ◽  
Entrapment Neuropathy ◽  
Injection Therapy ◽  
Entrapment Neuropathies ◽  
Perineural Injection ◽  
Novel Approach ◽  
Tunnel Syndrome

Current non-surgical treatment for peripheral entrapment neuropathy is considered insignificant and unsustainable; thus, it is essential to find an alternative novel treatment. The technique of perineural injection therapy using 5% dextrose water has been progressively used to treat many peripheral entrapment neuropathies and has been proven to have outstanding effects in a few high-quality studies. Currently, the twentieth edition of Harrison’s Principles of Internal Medicine textbook recommends this novel injection therapy as an alternative local treatment for carpal tunnel syndrome (CTS). Hence, this novel approach has become the mainstream method for treating CTS, and other studies have revealed its clinical benefit for other peripheral entrapment neuropathies. In this narrative review, we aimed to provide an insight into this treatment method and summarize the current studies on cases of peripheral entrapment neuropathy treated by this method.

Long-term outcome after perineural injection with 5% dextrose for carpal tunnel syndrome: a retrospective follow-up study

Rheumatology ◽  
2020 ◽  
Author(s):  
Tsung-Ying Li ◽  
Si-Ru Chen ◽  
Yu-Ping Shen ◽  
Chih-Ya Chang ◽  
Yu-Chi Su ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Symptom Relief ◽  
Injection Therapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Perineural Injection ◽  
Tunnel Syndrome

Abstract Objective Perineural injection therapy with 5% dextrose water is progressively becoming a mainstream method for treating carpal tunnel syndrome. However, its long-term outcome is still unknown. Hence, the purpose of this retrospective study was to investigate the long-term outcome after perineural injection therapy using 5% dextrose water. Methods A total of 185 patients diagnosed with carpel tunnel syndrome at least 1 year post-therapy were enrolled. All the patients underwent ultrasound-guided perineural injection therapy using 10 ml of 5% dextrose water at the outpatient department. In a structured telephone interview, the patients were asked about the outcome post-therapy compared with pre-injection. A symptom relief ≥50% indicated effective outcome, and a symptom relief <50% was indicative of a poor outcome. Results In total, 88.6% patients reported an effective outcome, and 11.4% rated the outcome as poor, after a mean of 2.2 injections with a mean of 1–3 years’ post-injection follow-up. The outcome was significantly related with severity level, and the patients that reported a poor outcome had a significantly higher incidence of severe grade compared with those who reported an effective outcome (52.4% vs 31.7%, P = 0.03). Patients with mild, moderate and severe grades, respectively, required an average of 1.7 (0.1), 2.4 (0.2) and 2.6 (0.3) injections to reach an effective outcome (P = 0.006) (severe vs mild, P = 0.008; moderate vs mild, P = 0.062). Conclusion Perineural injection therapy is a novel approach for treatment of carpal tunnel syndrome with safe and outstanding long-term effects.

Entrapment Neuropathy and Pregnancy

2018 ◽  
Author(s):  
Pariwat Thaisetthawatkul ◽  
Eric Logigian
Keyword(s):  
Peripheral Nerve ◽  
Water Retention ◽  
Hormone Secretion ◽  
Entrapment Neuropathy ◽  
Reproductive Hormone ◽  
Fibular Head ◽  
Meralgia Paresthetica ◽  
Entrapment Neuropathies ◽  
Tunnel Syndrome ◽  
Fibular Nerve

Entrapment neuropathy is caused by compression, angulation, or stretch of a peripheral nerve as it passes through a fibro-osseous canal such as the carpal or the cubital tunnel (in the case of the median or the ulnar nerves). In addition to true entrapment neuropathies, individual nerves can be injured at vulnerable anatomical locations such as the fibular head (in case of the fibular nerve). Pregnancy causes a variety of physiological changes related to reproductive hormone secretion that can affect peripheral nerve. These include weight gain, salt and water retention, edema and hyperglycemia.1 Two entrapment neuropathies that occur commonly in pregnancy are carpal tunnel syndrome and meralgia paresthetica.2 In addition to these true entrapment neuropathies, this chapter addresses other common focal mononeuropathies: femoral, obturator, and fibular neuropathies that may occur as a consequence of obstetrical procedures or of fetal or maternal positioning during delivery or in the postpartum period.

Entrapment Neuropathies: Electrodiagnostic Criteria

2019 ◽  
Vol 24 (6) ◽  
pp. 12-15
Author(s):  
Jay Blaisdell ◽  
James B. Talmage
Keyword(s):  
Nerve Conduction ◽  
Task Force ◽  
Conduction Block ◽  
Cubital Tunnel Syndrome ◽  
Conduction Delay ◽  
Test Results ◽  
Sixth Edition ◽  
Entrapment Neuropathies ◽  
Axon Loss ◽  
Tunnel Syndrome

Abstract Like the diagnosis-based impairment (DBI) method and the range-of-motion (ROM) method for rating permanent impairment, the approach for rating compression or entrapment neuropathy in the upper extremity (eg, carpal tunnel syndrome [CTS]) is a separate and distinct methodology in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition. Rating entrapment neuropathies is similar to the DBI method because the evaluator uses three grade modifiers (ie, test findings, functional history, and physical evaluation findings), but the way these modifiers are applied is different from that in the DBI method. Notably, the evaluator must have valid nerve conduction test results and cannot diagnose or rate nerve entrapment or compression without them; postoperative nerve conduction studies are not necessary for impairment rating purposes. The AMA Guides, Sixth Edition, uses criteria that match those established by the Normative Data Task Force and endorsed by the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM); evaluators should be aware of updated definitions of normal from AANEM. It is possible that some patients may be diagnosed with carpal or cubital tunnel syndrome for treatment but will not qualify for that diagnosis for impairment rating; evaluating physicians must be familiar with electrodiagnostic test results to interpret them and determine if they confirm to the criteria for conduction delay, conduction block, or axon loss; if this is not the case, the evaluator may use the DBI method with the diagnosis of nonspecific pain.

CUBITAL TUNNEL SYNDROME DUE TO GIANT CELL TUMOUR OF TENDON SHEATHS

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 89-91 ◽  
Author(s):  
G. Mitsionis ◽  
E. E. Pakos ◽  
I. Gavriilidis ◽  
Anna Batistatou
Keyword(s):  
Giant Cell ◽  
Giant Cell Tumour ◽  
Present Report ◽  
Cubital Tunnel Syndrome ◽  
Cell Tumour ◽  
Cubital Tunnel ◽  
Malignant Neoplasms ◽  
Entrapment Neuropathies ◽  
First Case ◽  
Tunnel Syndrome

Cubital tunnel syndrome is one of the most common entrapment neuropathies in adults. It is mainly caused by the depression of ulnar nerve from normal structures at the elbow area. Despite the fact that several pathgological entities can be potential mechanisms of the syndrome, the pathogenesis due to benign or malignant neoplasms is extremely rare. In the present report we describe the first case of cubital tunnel syndrome due to giant cell tumour of the tendon sheaths.

1287 A Comparison of Surgical Decompression and Steroid Injections to Treat Carpal Tunnel Syndrome: A Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
F La Costa
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Muscular Atrophy ◽  
Meta Analysis ◽  
Surgical Decompression ◽  
Optimal Treatment ◽  
Post Treatment ◽  
Entrapment Neuropathies ◽  
Tunnel Syndrome

Abstract Introduction Carpal tunnel syndrome (CTS) is caused by compression of the median nerve at the wrist. It accounts for 90% of all entrapment neuropathies, with a 7-16% in the UK. It has a significant impact on patients’ daily lives. Clinically, CTS results in paraesthesia, while extreme cases may involve muscular atrophy and weakness. There is currently a disparity between optimal treatments for CTS. Therefore, this paper aims to identify the optimal treatment for CTS with post-treatment BCTQ (Boston Carpal Tunnel Questionnaire) scores (including both functional and symptomatic severity) at 1, 3 and 6 months. Method The BCTQ scores for were sited from PubMed, Google Scholar and the University of Dundee Library search engine by entering key words such as “carpal tunnel syndrome”, “surgical decompression”, “surgical release” and “steroid injection”. Means and standard deviations for pre- and post-treatment after 1, 3 and 6 months were obtained. From this, forest plots were constructed using a software where steroid injection and surgical decompression were inputted separately, and effect sizes were then compared for 1, 3 and 6 months. Results The meta-analysis included reviewing 133 articles. The effect size was determined using the random effects model. Steroid injection was more effective than surgical decompression after 1 and 3 months. However, after 6 months, surgical decompression was more effective. Conclusions Identification of long-term relief of CTS through surgical decompression allows the reduction of symptom recurrence and thus costly follow-up appointments. This study provides robust clinical findings for the optimal treatment of CTS.

Salvage local treatment for localized radio-recurrent prostate cancer: a narrative review and future perspectives

2021 ◽  
Author(s):  
David Büchser ◽  
Rafael Medina ◽  
Esther Mayrata ◽  
Alba González ◽  
Marina Marban ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Treatment ◽  
Focus Ultrasound ◽  
Disease Recurrence ◽  
High Dose Rate ◽  
Narrative Review ◽  
High Dose ◽  
Treatment Techniques ◽  
Frequent Site ◽  
New Treatment

Although dose escalation protocols have improved biochemical control in prostate cancer radiotherapy, 10–45% of patients will experience disease recurrence. The prostate and seminal vesicles are the most frequent site of the first relapse. Traditionally, these patients have been managed with hormonal therapy, which is not curative. Recent improvements in diagnostic tests (e.g., multiparametric magnetic resonance and molecular imaging, including PET/CT scan with choline or Ga-PSMA) and new treatment techniques (e.g., stereotactic body radiation therapy or other minimally invasive alternatives like high-intensity focus ultrasound, cryoablation or high-dose-rate brachytherapy) offer new therapeutic strategies with the potential to cure some patients with limited adverse effects. In this narrative review, the authors present the most recent evidence to help identify the most suitable candidates for salvage treatment.

Sign in / Sign up

Export Citation Format

Share Document