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较少见的上肢单神经病。

Less common upper limb mononeuropathies.

机构信息

UMass Memorial Medical Center, Memorial Campus, 119 Belmont St, Worcester, MA 01605, USA.

出版信息

PM R. 2013 May;5(5 Suppl):S22-30. doi: 10.1016/j.pmrj.2013.03.021. Epub 2013 Mar 21.

Abstract

This article will focus on the less commonly injured nerves of the upper extremity. These nerves may be involved when trauma results in fractures, dislocations, or swelling with resultant nerve compression. Tumors and ganglions can also compress nerves, causing pain and, over time, demyelination or axon degeneration with weakness. Other mechanisms for upper limb nerve injury include participation in high-level sports, that is, those that generate torque about the arm and shoulder, abnormal stresses about the joints and muscles, or muscle hypertrophy, which may result in nerve injury. The goals of this review are to discuss the clinical presentation and possible causes of upper extremity nerve entrapments and to formulate an electrodiagnostic plan for evaluation. Descriptions of the appropriate nerve conduction studies or needle electromyographic protocols are included for specific nerves. The purpose of the electrodiagnostic examination is to evaluate the degree of nerve injury, axon loss over time, and later, evidence for reinnervation to assist with prognostication. The latter has implications for management of the neuropathy, including the type of exercises and therapy that may be indicated to help maintain the stability and motion of the involved joint(s) and promote strengthening over time as the nerve regenerates.

摘要

本文将重点介绍上肢较少受伤的神经。当创伤导致骨折、脱位或肿胀导致神经受压时,这些神经可能会受到影响。肿瘤和神经节也会压迫神经,导致疼痛,并随着时间的推移导致脱髓鞘或轴突变性,从而导致无力。上肢神经损伤的其他机制包括参与高水平运动,即产生手臂和肩部扭矩、关节和肌肉异常应力或肌肉肥大,这可能导致神经损伤。本文的目的是讨论上肢神经卡压的临床表现和可能的原因,并制定电诊断评估计划。本文还包括了特定神经的适当神经传导研究或针电极肌电图方案的描述。电诊断检查的目的是评估神经损伤的程度、轴突随时间的丢失,以及随后的神经再支配证据,以帮助预测预后。后者对神经病的治疗有影响,包括可能有助于维持受累关节的稳定性和运动并随着神经再生而随时间推移进行强化的锻炼和治疗类型。

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