The Thoracic Outlet Syndrome

Lascelles, R. G.; Möhr, Peter; Neary, D.; Bloor, K.

doi:10.1093/brain/100.3.601

Cited by 47 publications

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“…The EEG changes at both 5 and 8 years of age which had persisted did not necessarily confirm an epileptic tendency and the absence of changes when an attack was provoked was strong evidence that these episodes were not epileptic in origin nor were they the result of reflex anoxic seizures. Although the results of thoracic inlet compression have previously been described in terms of vascular (Lascelles et al 1977, Iraci et al 1981, Cormier et al 1989 and peripheral neuropathic symptoms (Lascelles et al 1977, Rayan 1988, only rarely has pain been described as a side effect of thoracic ribs and pseudoseizures have never been described as a complication. This case emphasizes the need for careful history taking and investigation before assuming that seizures are epileptic in nature.…”

Section: Discussionmentioning

confidence: 99%

Pseudoseizures as a complication of painful cervical ribs

Evans

1999

Develop Med Child Neuro

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Section: Discussionmentioning

confidence: 99%

Pseudoseizures as a complication of painful cervical ribs

Evans

1999

Develop Med Child Neuro

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“…ed. 5,10,14,18,20,29,31 The findings on nerve conduction studies in TOS have been the subject of much debate over the years. The main difficulty in comparing these studies is the lack of uniformity in the clinical diagnosis of TOS, which results in different conclusions.…”

Section: Discussionmentioning

confidence: 99%

Somatosensory evoked potentials: Lack of value for diagnosis of thoracic outlet syndrome

1988

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Twenty patients with thoracic outlet syndrome (TOS) seen at the Mayo Clinic between October 1984 and November 1985 were studied prospectively with routine nerve conduction studies, concentric needle examination, and bilateral median and ulnar somatosensory evoked potentials (SEPs). Results of nerve conduction studies and needle examination were abnormal in 30% of the patients, one patient having a reduced ulnar sensory nerve action potential amplitude and five others having neurogenic motor unit potential changes in the hand muscles. Ulnar SEPs were abnormal in three patients (15%), and median SEPs were abnormal in one patient, who also had abnormalities in ulnar SEPs. In patients with TOS, routine nerve conduction studies and needle examination were the most helpful electrophysiologic studies in excluding more common conditions. The routine use of ulnar SEPs in the evaluation of patients with TOS is probably not worthwhile.

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“…In recent years the controversy has been centred on the development of objective parameters to determine the value of surgical intervention. The neurological aspects of the thoracic outlet syndrome have been clarified by the work of Gilliatt et al'6 and Lascelles et al 17 The use of peripheral nerve conduction and F waves in the assessment of these patients has been well delineated by Gilliatt et al'2 and by other workers. In the presence of wasting and weakness there was consistent reduction in the amplitude of the ulnar sensory potential and a prolongation of the F wave latency.…”

Section: Discussionmentioning

confidence: 99%

Somatosensory evoked responses in the diagnosis of thoracic outlet syndrome.

Yiannikas¹,

Walsh²

1983

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY A study was made of 11 patients with cervical rib, and one patient with Klippel-Fiel syndrome and enlarged transverse processes to determine whether evoked potentials recorded from both Erb's points and the cervical spine in response to median and ulnar nerve stimulation provided information additional to that obtained by EMG and peripheral conduction studies. It was found that in seven patients who had pain and paraesthesias but no objective neurological signs both the peripheral and central conduction studies were within normal limits. By contrast, of five patients who had objective signs, conventional EMG and conduction studies were abnormal in three patients, but abnormalities of the evoked potentials obtained from ulnar nerve stimulation were obtained in all five patients. It is suggested that this application of evoked potential estimation is a useful addition to the more conventional peripheral investigations.The thoracic outlet syndrome is charactensed by a combination of pain in the arm provoked by traction, colour changes in the hand, and a radicular pattern of sensory loss and weakness with intact tendon reflexes. The incidence of thoracic outlet syndrome is uncertain, and the diagnostic criteria are disputed. The abnormalities in motor and sensory conduction in the peripheral segments of the median and ulnar nerves in patients with cervical ribs or bands have been well described by Gilliatt et all and Wulff and Gilliatt.2 Shahani et a13 Dorfman,4 and Eisen et al5 have studied the use of F wave latency in the diagnosis of thoracic outlet syndrome.The major abnormalities described in these studies were reduction in amplitudes of the ulnar sensory action potentials, chronic partial denervation in the intrinsic muscles of the involved hand (C8-T1) and prolongation of the F wave latency.However, in some patients with wasted hands the nerve conduction studies were normal and if there were no associated objective signs the diagnostic yield from electrophysiological studies was low.

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The Thoracic Outlet Syndrome

Cited by 47 publications

References 0 publications

Pseudoseizures as a complication of painful cervical ribs

Pseudoseizures as a complication of painful cervical ribs

Somatosensory evoked potentials: Lack of value for diagnosis of thoracic outlet syndrome

Somatosensory evoked responses in the diagnosis of thoracic outlet syndrome.

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