Compression syndrome involving the lateral antebrachial cutaneous nerve in high level quadriplegia.

This report describes an etiology for a compression syndrome involving the lateral antebrachial cutaneous nerve (LACN) that is unique to high level quadriplegia. Two cases are presented that involve this syndrome in C5-C6 quadriplegia. Electrodiagnostic techniques and normal values have previously been established for the LACN, but not involving high-level spinal cord injured patients. A series of asymptomatic high-level quadriplegics at various times since their spinal cord injury was studied for appropriate comparison with the symptomatic cases and previously reported normal values. In the cases described, electrodiagnostic evidence of compression was documented and a diagnostic block was performed by injecting a local anesthetic at Olson's point. Once the diagnosis was established, injection with a long-acting local anesthetic and corticosteroid was therapeutic.

Tarsal tunnel syndrome in runners.

Tarsal tunnel syndrome has only recently been noted to be a cause of foot and ankle pain in runners. The tarsal tunnel is located just posterior to the medial malleolus and may compress the posterior tibial nerve as it passes through it, producing numbness and paraesthesia in the foot. While the aetiology of this condition is frequently multifactorial, abnormal foot and ankle mechanics and excessive training tend to be the most commonly cited aetiological factors. Successful treatment of tarsal tunnel syndrome requires an accurate diagnosis by differentiating it from plantar fasciitis and Achilles tendinitis and then making proper biomechanical and training changes in the runner. Conservative treatment is generally successful, but occasionally surgical treatment is required to decompress the nerve.