Artikel
Multiple entrapment neuropathies: the role of surgery
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Focal lesions of the peripheral nervous system (mononeuritis multiplex) occur more frequently in patients affected by a multitude of intrinsic neuropathies such diabetes or HNPP than in the general population. A frequent finding is that this kind of lesion occurs at the common sites of nerve entrapment, with the ulnar nerve being involved very often in multiple compressive neuropathies. We investigated this pathological group of diseases particularly in the light of multiple entrapment neuropathies.
Methods: 60 consecutive cases, diagnosed for ulnar nerve entrapment as a main complaint, were studied between 2004–2006. 4 different nerves (contralateral ulnar, median, radial and peroneal nerve) were bilaterally tested over the common sites of entrapment neuropathy + EMG testing for radiculopathy.
Results: 30 patients (50%) were found to be positive for multiple entrapment neuropathy. In this group of patients 30 ulnar nerves were operated as the main complaint. 22 other nerves were operated as second or third entrapment in 18 patients. 26/30 (86,6%) ulnar nerves improved after operation. 20/22 (90,9%) other nerves improved after operation.
Conclusions: With an appropriate and careful selection of patients, surgery is a safe and effective treatment in multiple compression neuropathies when underlying intrinsic neuropathy is also diagnosed. We propose a reliable approach for the evaluation and management of peripheral nerve compressions.