Entrapment Neuropathies
Keywords:
Nerve entrapment, neuropathiesAbstract
Background: Entrapment neuropathies are common medical disorders frequently encountered in all fields of medicine. They are focal peripheral nerve injuries due to mechanical compression of a nerve through a fibro-osseous tunnel. Magnetic resonance imaging techniques provide useful information in dealing with these conditions.
Objectives: This was a review of current information on entrapment neuropathies.
Methodology: A literature search of current information on entrapment neuropathies was done. Articles on print and electronic publications were read and current information extracted.
Results: The causes were unknown in about 50% of cases. Nerve injuries were neuropraxia, axonotmesis or neurotmesis. Entrapment neuropathies usually existed close to joints where reduction in space and nerve pressure compromised neural blood supply resulting in anoxia. This made repetitive joint movement a major risk factor. Carpal tunnel syndrome (CTS) was commoner in women while cubital tunnel syndrome was commoner in men. The median nerve could be compressed in the carpal tunnel and lacertus fibrosus, ulnar nerve in the cubital tunnel, and the common peroneal at the fibular neck. Fibrous bands and arches compress the posterior interosseous nerve, deep motor branch of the radial nerve at the arcade of Frohse. Myofascial bands compress the sciatic nerve between the adductor magnus and biceps femoris. Nerve entrapment might follow soft tissue swellings in rheumatoid arthritis, or ganglion. Pregnancy, hypothyroidism, amyloidosis, diabetes, rheumatoid disease, myeloma and trauma to nerve increase risk of carpal tunnel syndrome. The idiopathic CTS were associated with females 40 -60 years old, hypercholesterolemia, stroke, and anticoagulation therapy. Pain, numbness, tingling sensation and loss of function were common complaints.Electrodiagnostic testing involving electromyography, nerve conduction studies, computed tomography and magnetic resonance imaging were used for diagnosis. Standard magnetic resonance pulse sequence helped in visualizing various anatomical features of peripheral nerves and the nearby tissues. Management included both medical and surgical treatments. Education on vocation especially sports offered non-drug therapy. Use of non-steroidal anti-inflammatory drugs and steroidal drugs gave variable results. Local injections with lidocaine were also successful. Refractory cases had surgical decompression.
Conclusion: Entrapment neuropathies were common conditions prevented by early identification and treatment.
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