Treatment of Clunial Nerve Entrapment Syndrome with Needle Knife Based on Principle of "Staging, Segmenting and Layering" / 中国中医药信息杂志

Treatment of clunial nerve entrapment syndrome with needle knife has the advantages of quick efficacy and easy application. However, because of the surgeons' lack of knowledge of the disease and the operation of different proficiency, there are differences in the treatment effects. This article introduced the guidance principle of"staging, segmenting and layering", which can improve the efficacy during treatment and be beneficial to the clinical application of all levels of clinical doctors.

Pudendal Nerve Entrapment Syndrome due to a Ganglion Cyst: A Case Report

Pudendal nerve entrapment syndrome is an unusual cause of chronic pelvic pain. We experienced a case of pudendal neuralgia associated with a ganglion cyst. A 60-year-old male patient with a tingling sensation and burning pain in the right buttock and perineal area visited our outpatient rehabilitation center. Pelvis magnetic resonance imaging showed the presence of multiple ganglion cysts around the right ischial spine and sacrospinous ligament, and the pudendal nerve and vessel bundle were located between the ischial spine and ganglion cyst at the entrance of Alcock's canal. We aspirated the lesions under ultrasound guidance, and consequently his symptoms subsided during a 6-month follow-up. This is the first report of pudendal neuralgia caused by compression from a ganglion cyst around the sacrospinous ligament.

Clinical observation of superior gluteal nerve entrapment syndrome treated with needle-in-row combined with herb-partition moxibustion / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects of need-in-row combined with herb-partition moxibustion,need-in-row and conventional acupuncture for superior gluteal nerve entrapment syndrome.</p><p><b>METHODS</b>Totally 105 patients were randomly assigned into a combination group,a need-in-row group and an acupuncture group,35 cases in each one. In the combination group and needle-in-row group,needle-in-row therapy was used at the pain tendon region of the pathological waist-hip part,and TDP was combined. Also,herb-partition moxibustion was applied at the same part after needle-in-row in the combined group. In the acupuncture group,conventional acupuncture was implemented at Weizhong(BL 40),Yanglingquan(GB 34),Zhibian(BL 54),Huantiao(GB 30),Sanyinjiao(SP 6) and Jiaji of L-L(EX-B 2),and TDP was applied. All the treatment was given once a day for four weeks. The changes of pain scores were compared after treatment.</p><p><b>RESULTS</b>The pain scores decreased obviously after treatment in all the groups(all<0.05). The scores of the combination group and the needle-in-row group declined more apparently than that of the acupuncture group(both<0.05). The score of the combination group reduced more obviously than that of the needle-in-low group(<0.05). The markedly effective rates of the combination group and the needle-in-row group were 88.6%(31/35) and 68.6%(24/35),which were higher than 40.0%(14/35) of the acupuncture group(both<0.05),and the markedly effective rate of the combination group was better than that of the needle-in-row group(<0.05).</p><p><b>CONCLUSIONS</b>Need-in-row combined with herb-partition moxibustion show definite effect for superior gluteal nerve entrapment syndrome,and it is better than those of simple needle-in-row therapy and conventional acupuncture.</p>

Expression and role of connective tissue growth factor in the peripheral nerve after chronic compression injury / 中华显微外科杂志

Objective To investigate the effects of connective tissue growth factor (CTGF) on the chronic peripheral nerve compression injury and explore the function of CTGF in peripheral nerve compression injury and repair. Methods From July 2010 to September 2010, fifty aduh male SD rats were randomly divided into group A and B: group A (sham-operated group): only exposed the sciatic nerve; group B (compression group): undergone sciatic nerve entrapment operation on the right hind leg according to the method which Mackinnon adopted when he established the model of chronic sciatic nerve compression.Electron microscopy,immunohistochemistry,RT-PCR and Western-blot were performed to observe the morphological changes of the compressed nerve tissue and to determine the level of CTGF,collagen- Ⅰ,Ⅲ (COL- Ⅰ,Ⅲ),2,4,6,8,10 weeks after the surgery,respectively. Results After sciatic nerve compression,the collagen in nerve increased ; The expression of CTGF and COL- Ⅰ, Ⅲ in sciatic nerve of compressed group increased, which was statistically different compared with the sham-operation group (P ＜ 0.05); In the meanwhile,the contents of CTGF and COL- Ⅰ,Ⅲ were positively correlated in a certain period. Conclusion Peripheral nerve fibrosis can be caused by chronic nerve compression.The expression of COL- Ⅰ,Ⅲ in sciatic nerve increased and CTGF get involved in the pathophysiological process, which suggests that CTGF plays an important role in the process of neural injury and fibrosis.

A Case Report of Nerve Entrapment Syndrome with Lymphedema

PURPOSE: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. METHODS: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. RESULTS: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. CONCLUSION: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

Clinical and electrophysiological study of entrapment syndrome of recurrent branch of median nerve / 中华物理医学与康复杂志

Objective To investigate the clinical and electrophysiological characteristics of entrapment syndrome involving the median nerve's recurrent branch. Methods Fourteen cases (10 male, 4 female, mean age 34.7) of medial nerve recurrent branch entrapment syndrome were retrospectively analyzed in this study with regard to their clinical and electrophysiological data. Results Normal sensory conduction velocity ( SCV ) and normal amplitude of the sensory nerve action potential ( SNAP) were found, but there was a delay of the distal motor latency (DML) in all 14 cases. The compound muscle action potential (CMAP) amplitude was decreased in 11 cases, and normal motor conduction velocity (MCV) was demonstrated in 12 cases. Fibrillation potentials and/or positive sharp waves were detected in the abductor pollicis brevis muscle in 12 cases and in the opponens pollicis muscle in 14 cases. EMGs of the flexor digitorum superficialis and pronator quadratus muscle were normal in all 14 cases. Conclusion Electrophysiological examination could provide objective and reliable data for diagnosing and differentially diagnosing median nerve recurrent branch entrapment syndrome.