Peripheral nerve fascicles: Anatomy and clinical relevance

Stewart, John

doi:10.1002/mus.10454

Cited by 219 publications

(152 citation statements)

References 69 publications

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“…Variable sensory disturbances were present in all patients, especially in the distal web space pattern. [15] Hypoesthesia was present in 51 hands (82%), while 36 hands (58%) had anesthesia at the tips of the fingers. Hypoesthesia at the first web space was present in 49 hands (79%).…”

Section: Resultsmentioning

confidence: 99%

Carpal tunnel syndrome in manual tea harvesters

Çiftdemir

Çopuroğlu

Özcan

et al. 2013

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada elle yapılan çay tarımına bağlı karpal tünel sendromunun (KTS) fizyopatolojik ve cerrahi boyutu, sinir ileti çalışmaları ve klinik skorlama sistemleri kullanarak değerlendirildi. Hastalar ve yöntemler: Şiddetli KTS nedeniyle cerrahi tedavi uygulanan 56 tarım işçisinin klinik ve nörofizyo-lojik skorları ile klinik ve mesleki değişkenleri; Boston anketi, İtalyan KTS çalışma grubunun modifiye kriterleri ve İtalyan KTS çalışma grubunun modifiye nörofizyolojik evreleme sistemi kullanılarak istatistiksel olarak değerlen-dirildi. Bulgular: Hastaların klinik evreleri, yaşları, toplam çalışma süreleri ile semptomların süresi arasında anlamlı istatistiksel ilişki bulundu. Hastalardaki KTS'nin nörofizyolojik evreleri ve semptomların süresi ile cerrahi tedavi öncesi ve sonrasında fonksiyonel sonuçlar arasında da anlamlı bir istatistiksel ilişki saptandı. Sonuç: Elle yapılan çay tarımının mesleğe bağlı KTS gelişimi için mesleki bir risk faktörü olabileceği düşünüldü. Bu alanda çalışan isçilerde KTS'nin cerrahi tedavisi ile tatminkar sonuçlar elde edildi.Anahtar sözcükler: Tarım isçileri hastalıkları; karpal tünel sendromu; sinir basısı sendromları; cerrahi uygulamalar, küçük; çay.Objectives: This study aims to present the physiopathological and surgical aspects of carpal tunnel syndrome (CTS) related to manual tea harvesting based on nerve conduction studies and clinical scoring systems. Patients and methods: Clinical and neurophysiological scores as well as clinical and occupational variables were statistically analyzed using Boston questionnaire, modified criteria of Italian CTS study group, and modified neurophysiologic grading system of Italian CTS study group in 56 agricultural laborers who underwent surgery due to severe CTS. Results: A statistically significant correlation was found among the clinical stages of the patients and age, working duration and duration of symptoms. There was a statistically significant relationship among neurophysiologic grades of the CTS in patients and the duration of symptoms and functional outcomes before and after surgery. Conclusion: We concluded that manual tea harvesting might be an occupational risk factor for work-related CTS development. Surgical treatment of CTS among manual tea harvesters revealed satisfactory results.

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Section: Resultsmentioning

confidence: 99%

Carpal tunnel syndrome in manual tea harvesters

Çiftdemir

Çopuroğlu

Özcan

et al. 2013

Eklem Hastalik Cerrahisi

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“…For example, it is intriguing to speculate that the fascicles with distinctly bimodal distributions innervate distal tissue, dedicating the large and fast nerve fibers to govern behaviors that require high responsiveness (analogous to the giant neurons that coordinate escape responses in invertebrates and fish) and dedicating the small nerve fibers to preserving high resolution. However, as it is not yet known to what degree somatotopic organization occurs in more proximal peripheral nerves such as the sciatic nerve (Stewart, 2003), this possibility remains uncertain. There were several limitations to this study in addition to the previously mentioned effects of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Sensorimotor responsiveness and resolution in the giraffe

O’Connor

Brøndum

et al. 2013

Journal of Experimental Biology

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SUMMARYThe ability of an animal to detect and respond to changes in the environment is crucial to its survival. However, two elements of sensorimotor control -the time required to respond to a stimulus (responsiveness) and the precision of stimulus detection and response production (resolution) -are inherently limited by a competition for space in peripheral nerves and muscles. These limitations only become more acute as animal size increases. In this paper, we investigated whether the physiology of giraffes has found unique solutions for maintaining sensorimotor performance in order to compensate for their extreme size. To examine responsiveness, we quantified three major sources of delay: nerve conduction delay, muscle electromechanical delay and force generation delay. To examine resolution, we quantified the number and size distribution of nerve fibers in the sciatic nerve. Rather than possessing a particularly unique sensorimotor system, we found that our measurements in giraffes were broadly comparable to size-dependent trends seen across other terrestrial mammals. Consequently, both giraffes and other large animals must contend with greater sensorimotor delays and lower innervation density in comparison to smaller animals. Because of their unconventional leg length, giraffes may experience even longer delays compared with other animals of the same mass when sensing distal stimuli. While there are certainly advantages to being tall, there appear to be challenges as well -our results suggest that giraffes are less able to precisely and accurately sense and respond to stimuli using feedback alone, particularly when moving quickly.

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“…The stressed carpal transverse ligament could also stress the Guyon canal, and the ulnar nerve can occasionally be entrapped in this region 17 . Could the CTS symptoms in the entire hand, described in approximately 40-50% of patients [18][19][20] be due to a subclinical compression of the ulnar nerve in the Guyon canal?…”

Section: Discussionmentioning

confidence: 99%

Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome

Araújo

Kouyoumdjian

2007

Arq. Neuro-Psiquiatr.

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-Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32°C, and after wrist/hand cooling to <27°C in ice water. After cooling, there was a significantly greater increase in PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.KEY WORDS: carpal tunnel syndrome, nerve conduction studies, median nerve, temperature, ulnar nerve.influência do resfriamento nos parâmetros de condução nervosa mista do mediano e ulnar na síndrome do túnel do carpo RESUMO -Temperatura é uma variável comum e importante que modifica os parâmetros de condução nervosa na prática eletrodiagnóstica. Neste trabalho nós estudamos o efeito do esfriamento na diferença de latências palmares entre o nervo mediano e ulnar (PMU), segmento palma-pulso, utilizada rotineiramente para o eletrodiagnóstico da síndrome do túnel do carpo (STC). Foram estudados 22 controles (19 mulheres, média de idade 42,1 anos, 44 mãos) e 25 pacientes (25 mulheres, média de idade 46,6 anos, 34 mãos) com diagnóstico de STC leve. PMU foi obtida em temperatura usual (>32°C), e após resfriamento de mão/ pulso em água com gelo (<27°C). Após o resfriamento houve aumento significativo na PMU e na latência mista palmar do nervo ulnar nos pacientes quando comparados aos controles. Nós concluímos que o resfriamento modifica significativamente a PMU e propomos que as latências obtidas em nervos submetidos à compressão reagem de maneira mais acentuada ao frio e isso poderia ser uma arma útil para o eletrodiagnóstico da STC incipiente. Da mesma forma, houve reação mais acentuada ao frio no estudo da latên-cia mista palmar do nervo ulnar nos pacientes mas não nos controles, que poderia levantar a hipótese de compressão subclínica do nervo ulnar. PALAVRAS-CHAVE: síndrome do túnel do carpo, condução nervosa, nervo mediano, temperatura, nervo ulnar.

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Peripheral nerve fascicles: Anatomy and clinical relevance

Cited by 219 publications

References 69 publications

Carpal tunnel syndrome in manual tea harvesters

Carpal tunnel syndrome in manual tea harvesters

Sensorimotor responsiveness and resolution in the giraffe

Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome

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