Adult ; Aged ; Elbow ; innervation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nerve Compression Syndromes ; physiopathology ; surgery ; Recovery of Function ; Ulnar Nerve ; physiopathology ; surgery

OBJECTIVE: To search the features and the treatment of vascular compressive syndrome caused by the facial, acoustic nerves. METHOD: Ten cases of vascular compressive syndrome caused by the facial, acoustic nerves were included in the group,which were treated by microvascular decompression(MVD). Besides, the microanatomic relationship between the nerve and their adjacent vessel at the root exit zone (REZ) were observed under microscope or nasoendoscopy in MVD. RESULT: Tinnitus, vertigo and facial spasm disappeared after MVD in 7 cases (70%), improved in 2 cases (20%), and relapse in 1 case (10%). All cases were found out vessels compressing at the root zone of the facial nerve and the auditory nerve. CONCLUSION The Clinical features of vascular compressive syndrome caused by the facial, acoustic nerves are facial spasm, tinnitus, and vertigo, for which microvascular decompression has a positive therapeutic effect as long as the diagnosis is correct.
Adult ; Cochlear Nerve ; Decompression, Surgical ; Facial Nerve ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; physiopathology ; surgery

OBJECTIVETo investigate the causes and operations for entrapment syndrome of posterior interosseous nerve caused by elbow cyst.

METHODSForm March 2005 to March 2012,5 patients with entrapment syndrome of posterior interosseous nerve caused by elbow cyst were treated with surgical excision and neurolysis including 3 males and 2 females with an average age of 50.4 years old ranging from 35 to 60 years old. The course was from 3 to 10 months with an average of 6.3 months. The main clinical symptoms were pain on the outside of the forearm. The extension muscle power of the metacarpophalangeal joints at the fingers and the wrist had decreased. The EMC showed neurogenic damage or nerve conduction slowing down. According to the functional neurological evaluation standard of British Medical Research Institute ,the motion and sensory function after nerve injury was assessed.

RESULTSPatients were followed up for 3 to 15 months with an average of 8.5 months. Wound healing in patients was good after the operations. There were no significant complications. Three patients were excellent (M4S3+) and 2 patients were good (M3S3). The hand joint function of 5 patients recovered well after operation.

CONCLUSIONThe surgical excision and neurolysis for treatment of entrapment syndrome of posterior interosseous nerve caused by elbow ganglions cyst can remove the entrapment syndrome of the posterior interosseous nerve thoroughly ,promote the neurological function recovery. According to the functional evaluation standard ,operations achieved better therapeutic effect.

Adult ; Bone Cysts ; complications ; Elbow ; innervation ; surgery ; Female ; Fingers ; physiopathology ; Humans ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; physiopathology ; surgery ; Wrist ; physiopathology

OBJECTIVESTo investigate anatomical mechanism of the ulnar wrist pain caused by the compression of the dorsal branch of the ulnar nerve, and discuss the diagnosis and treatment of the compression.

METHODS40 sides of the upper extremities of adult cadavers were studied anatomically. The dorsal branch of the ulnar nerve and its relationship to the surroundings was dissected and observed grossly and microscopically. 13 cases of the compression of the dorsal branch of the ulnar nerve were treated and followed up.

RESULTSThe dorsal branch of the ulnar nerve was penetrated from the deep of the flexor carpi ulnaris muscle 5.6 approximately 6.8 cm proximally from the styloid process of the ulna, then ran along the ulna and divided into 2 approximately 3 big branches at the medial side of the head of the ulna. The transverse branch was apt to injury during wrist movement as it crossed or rounded the head of the ulna where it was close to the peristeam. Seven of 13 cases of the compression of the dorsal branch of the ulnar nerve were treated by local block, and 6 by surgical neurolysis. Nine cases of this group got showed good effect without recurrence after 4 months to 1 year follow-up.

CONCLUSIONThe anatomical basis of the compression of the dorsal branch of the ulnar nerve is repetitive traction to this nerve during wrist movement, and the compression of the transverse branch is the main cause of ulnar wrist pain. The compression of the dorsal branch of the ulnar nerve should be considered to the patients with ulnar wrist pain and abnormal sensation along the dorsal ulnar side of hand.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Ulnar Nerve ; anatomy & histology ; Ulnar Nerve Compression Syndromes ; diagnosis ; physiopathology ; therapy ; Wrist ; anatomy & histology

OBJECTIVETo evaluate the urodynamic characteristics of the chronic impairment of cauda equina caused by lumbar disk herniation.

METHODSClinical data and urodynamic parameters of 67 male patients with lumbar disk herniation were retrospectively analyzed. Lower urinary obstruction was excluded from the cohort using the Lin-PURR analysis. Patients were divided into group A (normal detrusor function), group B (detrusor underactivity) and group C (detrusor areflexia) according to the detrusor contraction function analyzed in Lin-PURR. Clinical data and urodynamic parameters were analyzed statistically between these groups.

RESULTSThe category of the detrusor contraction function had a significant effect on the urodynamic parameters. There were significant differences in the maximum flow rate (Q(max)), maximum pressure (P(max)), pressure at the maximum flow (P(det Qmax)) and post-voiding residual urine (PVR) among group A, B and C. There were significant differences in the first sensation volume of the bladder and the maximum cystometric capacity between group A and C, B and C, but no significance was found between group A and B. There was no significant difference in age, disease duration, and compliance of the bladder among 3 groups.

CONCLUSIONSUrodynamic study is important in exploring the severity of the chronic impairment of cauda equina caused by lumbar disk herniation. Detrusor areflexia and loss of bladder sensory indicate more severe degree of impairment of the cauda equine. Q(max) and PVR are helpful in early diagnosis of the chronic impairment of cauda equina.

Adult ; Aged ; Aged, 80 and over ; Cauda Equina ; Chronic Disease ; Humans ; Intervertebral Disc Displacement ; complications ; physiopathology ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; physiopathology ; Retrospective Studies ; Urodynamics

OBJECTIVETo study the effect of botulinum toxin type A (BTXA) on spontaneous discharge and sympathetic- sensory coupling in chronically compressed dorsal root ganglion (DRG) neurons in rats.

METHODSIn chronically compressed rat DRG, spontaneous activities of the single fibers from DRG neurons were recorded and their changes observed after BTAX application on the damaged DGR. Sympathetic modulation of the spontaneous discharge from the compressed DRG neurons was observed by electric stimulation of the lumbar sympathetic trunk, and the changes in this effect were evaluated after intravenous BTXA injection in the rats.

RESULTSActive spontaneous discharges were recorded in the injured DRG neurons, and 47 injured DRG neurons responded to Ca2+-free artificial cerebrospinal fluid but not to BTXA treatment. Sixty-four percent of the neurons in the injured DRG responded to sympathetic stimulation, and this response was blocked by intravenously injection of BTXA.

CONCLUSIONBTXA does not affect spontaneous activities of injured DRG neurons, but blocks sympathetic-sensory coupling in these neurons.

Action Potentials ; drug effects ; Animals ; Botulinum Toxins, Type A ; pharmacology ; Ganglia, Spinal ; cytology ; drug effects ; physiopathology ; Nerve Compression Syndromes ; physiopathology ; Neurons ; drug effects ; Rats ; Rats, Sprague-Dawley

Electrophysiologic carpal tunnel syndrome (CTS) is common and is frequently asymptomatic in diabetics. In order to evaluate the clinical significance of asymptomatic electrophysiologic CTS, the nerve conduction studies (NCS) of 48 diabetics with asymptomatic electrophysiologic CTS were compared with those of 56 age and gender-matched controls, as well as 50 patients with symptomatic CTS without diabetes. Nerve conduction velocities of the ulnar, peroneal, and posterior tibial nerves were significantly slower in diabetics with asymptomatic electrophysiologic CTS than in normal controls. Compared to symptomatic non-diabetic CTS, there was also significant slowing of the median and ulnar nerve conduction velocities in asymptomatic diabetic CTS. However, in diabetics with asymptomatic CTS, abnormalities of the distal segment of the median NCS were more prominent compared with those of all the other tested nerves. These findings suggested that asymptomatic electrophysiologic CTS in diabetics is a manifestation of increased vulnerability to the entrapment of the peripheral nerve.
Carpal Tunnel Syndrome/physiopathology* ; Carpal Tunnel Syndrome/complications* ; Diabetes Mellitus/complications* ; Diabetic Neuropathies/physiopathology ; Electrophysiology ; Female ; Human ; Male ; Middle Age ; Nerve Compression Syndromes/physiopathology ; Neural Conduction ; Polyneuropathies/physiopathology ; Reference Values

OBJECTIVETo study the effects of acetylcholine (ACh) on spontaneous discharges of compressed rat dorsal root ganglion (DRG) neurons.

METHODSIn chronically compressed DRG model, the spontaneous discharge of a single fiber from the DRG neuron in response to ACh treatment was recorded.

RESULTSActive spontaneous discharges were recorded in the injured DRG, and 77.9% of the injured DRG neurons responded to Ach treatment in the manner of simple excitation, or excitation followed by inhibition. The responses were enhanced with the increase of Ach concentration.

CONCLUSIONInjured DRG remains active in spontaneous discharges, which can be significantly influenced by ACh treatment.

Acetylcholine ; pharmacology ; Action Potentials ; drug effects ; Animals ; Dose-Response Relationship, Drug ; Female ; Ganglia, Spinal ; physiopathology ; Male ; Nerve Compression Syndromes ; physiopathology ; Neurons ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Time Factors ; Vasodilator Agents ; pharmacology