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小儿外周神经损伤:文献综述。第二部分:卡压性神经病。

Peripheral nerve injuries in the pediatric population: a review of the literature. Part II: entrapment neuropathies.

作者信息

Costales Javier Robla, Socolovsky Mariano, Sánchez Lázaro Jaime A, Costales David Robla

机构信息

Universidad de León, León, Spain.

Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.

出版信息

Childs Nerv Syst. 2019 Jan;35(1):37-45. doi: 10.1007/s00381-018-3975-7. Epub 2018 Sep 12.

Abstract

INTRODUCTION

Entrapment neuropathies are infrequent in children, and therefore remain unrecognized. The incidence of radial, median, and cubital mononeuropathies are all similar. Despite the rarity of such cases, extensive, albeit scattered, literature has accumulated concerning entrapment neuropathies in children.

OBJECTIVE

To the literature concerning entrapment neuropathies in children.

METHODS

A systematic review of the existing literature has been made.

RESULTS

The management of chronic pediatric pain is very important in such patients to prevent youths from experiencing prolonged absences from school, sports, or other productive activities, and limit the psychological burden of chronic disease. Nonsurgical treatment of both cubital and carpal tunnel syndromes has been disappointing in pediatric patients, with only limited success; and, to date, there is no clear explanation for the outcome differences generated by nonsurgical management between adults and youths. Simple decompression of the ulnar nerve at the elbow also has much higher rates of failure in children than in adults.

CONCLUSIONS

The presence of an entrapment neuropathy (specially carpal tunnel syndrome) in a pediatric-age patient should alert medical care providers to the potential of some underlying genetic condition or syndrome.

摘要

引言

儿童卡压性神经病并不常见,因此常未被识别。桡神经、正中神经和尺神经单神经病的发病率相似。尽管此类病例罕见,但关于儿童卡压性神经病的文献已积累得较为丰富,尽管这些文献较为分散。

目的

综述有关儿童卡压性神经病的文献。

方法

对现有文献进行系统综述。

结果

对于此类患者,慢性儿童疼痛的管理非常重要,可防止青少年长时间缺课、不参加体育活动或其他有益活动,并减轻慢性病的心理负担。在儿科患者中,尺管综合征和腕管综合征的非手术治疗效果不佳,仅取得有限成功;迄今为止,对于成人和青少年非手术治疗产生不同结果的原因尚无明确解释。儿童肘部尺神经单纯减压术的失败率也远高于成人。

结论

儿科患者出现卡压性神经病(尤其是腕管综合征)应提醒医疗服务提供者注意某些潜在遗传疾病或综合征的可能性。

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