1/85. Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy.MRI was performed on the spinal roots, brachial and lumbar plexuses of 14 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). hypertrophy of cervical roots and brachial plexus was demonstrated in eight cases, six of whom also had hypertrophy of the lumbar plexus. Of 11 patients who received gadolinium, five of six cases with hypertrophy and one of five without hypertrophy demonstrated enhancement. All patients with hypertrophy had a relapsing-remitting course and a significantly longer disease duration. Gross onion-bulb formations were seen in a biopsy of nerve from the brachial plexus in one case with clinically evident nodular hypertrophy. We conclude that spinal root and plexus hypertrophy may be seen on MRI, particularly in cases of CIDP of long duration, and gadolinium enhancement may be present in active disease.- - - - - - - - - - ranking = 1keywords = plexus (Clic here for more details about this article) |
2/85. Lateral antebrachial cutaneous neuropathy in a windsurfer.Lateral antebrachial cutaneous neuropathy (LACN) was diagnosed in a young woman who developed pain and paresthesias in the right forearm after a long day of windsurfing (board sailing). The symptoms resolved with conservative treatment, including cessation of windsurfing and a brief course of oral corticosteroids. There was a permanent residual cutaneous sensory deficit in the distribution of the LACN. LACN is important to recognize because the symptomatology may mimic pathology of a cervical root, the brachial plexus, and the radial and median nerves at the level of the elbow.- - - - - - - - - - ranking = 0.11111111111111keywords = plexus (Clic here for more details about this article) |
3/85. Recurrent idiopathic lumbosacral plexopathy.Recurrent idiopathic lumbosacral plexopathy has rarely been reported in the literature. The present report describes a 59-year-old man presenting with recurrent episodes of acute leg pain, followed by weakness. After each episode, symptoms progressed for several months before peaking. Thereafter, gradual recovery ensued. Electrodiagnostic studies revealed primarily a patchy pattern of denervation in the distribution of part of the lumbosacral plexus, sparing the paraspinal muscles. Extensive evaluations for an underlying cause were unrevealing. Thus, these episodes are suggestive of recurrent idiopathic lumbosacral plexopathy, and the present case is compared with previous cases reported in the literature.- - - - - - - - - - ranking = 0.11111111111111keywords = plexus (Clic here for more details about this article) |
4/85. Lumbosacral plexopathy after dual kidney transplantation.A 58-year-old man underwent dual kidney transplantation. He was unable to move his right leg after surgery. This was caused by extensive lumbosacral plexopathy on the side of surgery. Lumbosacral plexopathy after kidney transplantation is uncommon, because the plexus has rich anastomotic blood supply, and ischemic injury is unlikely. However, isolated femoral neuropathy after renal transplantation has been reported, as the distal portion of this nerve is supplied by branches of internal iliac artery only and is more prone to ischemic injury during surgery. Dual-kidney transplantation involves a larger dissection, and the procedure takes 60 to 90 minutes longer than single-kidney transplantation. It involves more vascular reconstruction. This may predispose the lumbosacral plexus to ischemic injury. To the best of our knowledge, this is the first reported case of lumbosacral plexopathy after a dual kidney transplantation, and this may be seen more frequently because this procedure is becoming more common.- - - - - - - - - - ranking = 0.22222222222222keywords = plexus (Clic here for more details about this article) |
5/85. A myoelectrically controlled shoulder-elbow orthosis for unrecovered brachial plexus injury.Two myoelectrically controlled battery powered shoulder-elbow orthoses manufactured individually for two traumatic unilateral brachial plexus injury cases are reported. The first case was 24 years old and the other was 6 years old. Both patients had undergone unsuccessful microsurgical nerve repair procedures leaving them with elbow and shoulder paralysis and some residual hand motion. Manufactured orthoses were made of lightweight thermoplastic polyethylene. They stabilised the affected shoulder joint in the neutral position. elbow extension and flexion were activated by a myoelectrically controlled battery powered orthosis, and the active range of motion of the elbow was between 60 and 140 degrees. These orthoses achieved elbow motions at a speed of 16 degrees per second. The rehabilitation time was 3 months in both patients. The older patient was rehabilitated using a 1 kg mass, and the younger one with 0.5 kg mass, throughout the full range of active elbow motions. After 21 months it was found, in both cases, that the orthotic treatment had been successful and that the patients had been given the ability to engage in two-handed activities of daily living.- - - - - - - - - - ranking = 0.55555555555556keywords = plexus (Clic here for more details about this article) |
6/85. The value of MR neurography for evaluating extraspinal neuropathic leg pain: a pictorial essay.SUMMARY: Fifteen patients with neuropathic leg pain referable to the lumbosacral plexus or sciatic nerve underwent high-resolution MR neurography. Thirteen of the patients also underwent routine MR imaging of the lumbar segments of the spinal cord before undergoing MR neurography. Using phased-array surface coils, we performed MR neurography with T1-weighted spin-echo and fat-saturated T2-weighted fast spin-echo or fast spin-echo inversion recovery sequences, which included coronal, oblique sagittal, and/or axial views. The lumbosacral plexus and/or sciatic nerve were identified using anatomic location, fascicular morphology, and signal intensity as discriminatory criteria. None of the routine MR imaging studies of the lumbar segments of the spinal cord established the cause of the reported symptoms. Conversely, MR neurography showed a causal abnormality accounting for the clinical findings in all 15 cases. Detected anatomic abnormalities included fibrous entrapment, muscular entrapment, vascular compression, posttraumatic injury, ischemic neuropathy, neoplastic infiltration, granulomatous infiltration, neural sheath tumor, postradiation scar tissue, and hypertrophic neuropathy.- - - - - - - - - - ranking = 0.22222222222222keywords = plexus (Clic here for more details about this article) |
7/85. Transient right phrenic nerve palsy associated with central venous catheterization.An 85-yr-old woman with advanced sigmoid colon cancer developed right phrenic nerve palsy following central venous catheterization for preoperative nutritional and fluid balance improvement. The central venous catheter was successfully placed via the left subclavian vein at the first attempt. blood returned freely through the catheter. The chest x-ray film taken immediately after the catheterization showed the proper placement of the catheter, but it revealed a significant right hemidiaphragmatic elevation indicating phrenic nerve palsy. A chest computed tomography scan and bronchoscopy were normal. As the patient did not complain of dyspnoea and vital signs were normal, tumour resection was performed. The operative and postoperative course was uneventful. The chest x-ray film after the surgery still showed the elevation of the right hemidiaphragm. It resolved completely within 3 days of withdrawing the central venous catheter by 3 cm on the fourth postoperative day. We concluded the likely cause of the phrenic nerve palsy was that the catheter tip impinged upon the thin venous wall and compressed the phrenic nerve running alongside the superior vena cava.- - - - - - - - - - ranking = 0.0003466973838462keywords = chest (Clic here for more details about this article) |
8/85. An elevated hemidiaphragm 3 months after internal jugular vein hemodialysis catheter placement.phrenic nerve palsy following central venous catheterization is a rare complication and is not well recognized. We present a 33 months old girl who has renal failure secondary to nephrotic syndrome. A left internal jugular catheter was placed using the Seldinger technique after a single injection of 2 ml prilocaine hydrochloride for local anesthesia and a single internal jugular vein cannulation. Subsequent chest roentgenograms confirmed proper catheter and diaphragm position. Three months after catheter placement, decreased breath sounds on the left side of the chest were noted. Left phrenic nerve palsy was demonstrated with fluoroscopy and electromyography with external diaphragmatic electrodes. The nerve damage was delayed after catheter placement, it seems unlikely that it was related to direct nerve trauma from the cannulation needle, local anesthetic infiltration of the nerve, or subsequent hematoma formation in this case. The phrenic nerve is in close proximity to both the catheter and the vein in which the catheter rests, an inflammatory reaction related to the catheter has been suggested as the cause for the nerve damage.- - - - - - - - - - ranking = 0.0002311315892308keywords = chest (Clic here for more details about this article) |
9/85. Electrodiagnostic characteristics of Wegener's granulomatosis-associated peripheral neuropathy.Wegener's granulomatosis is a multisystem disease distinguished by a triad of necrotizing granulomatous vasculitis involving the upper and lower respiratory tracts, glomerulonephritis and systemic, small vessel vasculitis. The latter can cause neurologic manifestations when the vasa nervorum are affected. A 53-yr-old male presented with a 3-mo history of chronic nasal congestion, arthralgias, pruritic maculopapular eruption, epistaxis and lower extremity weakness. Subsequent lung and chest wall biopsies confirmed diagnosis of Wegener's granulomatosis. Summary of electrodiagnostic data obtained on initial presentation and comparison with later study indicated a sensorimotor polyneuropathy with wide-spread axonal involvement noted particularly in the distal lower extremity musculature. Electrodiagnostic documentation of rapid progression proved useful in directing alteration of immunosuppressive therapy, with favorable clinical and functional outcome. We believe this is the second case presented of a patient with documented Wegener's granulomatosis and overt clinical evidence of poly-neuropathy in whom both electroneurographic and electromyographic studies are described. Electrodiagnostic results are presented with discussion of pertinent literature.- - - - - - - - - - ranking = 0.0001155657946154keywords = chest (Clic here for more details about this article) |
10/85. Anticoagulant-induced shoulder hematoma producing brachial plexus neuropathy--case reports.Hemorrhagic complications from anticoagulants are common and may manifest in any part of the human body. skin discoloration, pain, tenderness, and soft-tissue swelling may be the main clinical features. The authors present 3 extraordinary cases of brachial plexus neuropathy associated with anticoagulant-induced hemorrhage. The signs, symptoms, important differentials, and clinical treatment are described with regard to the pathologic anatomy.- - - - - - - - - - ranking = 0.55555555555556keywords = plexus (Clic here for more details about this article) |
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