entrapment neuropathy

neuropathy

[noo͡-rop´ah-the] any of numerous functional disturbances and pathologic changes in the peripheral nervous system. The etiology may be known (e.g., arsenical, diabetic, ischemic, or traumatic neuropathy) or unknown. encephalopathy" >encephalopathy and myelopathy" >myelopathy are corresponding terms relating to involvement of the brain and spinal cord. The term is also used to designate noninflammatory lesions in the peripheral nervous system, in contrast to inflammatory lesions (neuritis). adj., adj neuropath´ic.alcoholic neuropathy neuropathy due to thiamine deficiency in chronic alcoholism.Denny-Brown's sensory neuropathy hereditary sensory radicular neuropathy.diabetic neuropathy a complication of diabetes mellitus" >diabetes mellitus consisting of chronic symmetrical sensory polyneuropathy affecting first the nerves of the lower limbs and often affecting autonomic nerves. Pathologically, there is segmental demyelination of the peripheral nerves. An uncommon, acute form is marked by severe pain, weakness, and wasting of proximal and distal muscles, peripheral sensory impairment, and loss of tendon reflexes. With autonomic involvement there may be orthostatic hypotension, nocturnal diarrhea, retention of urine, impotence, and small diameter of the pupils with sluggish reaction to light.entrapment neuropathy any of a group of neuropathies, such as carpal tunnel syndrome, caused by mechanical pressure on a peripheral nerve.hereditary motor and sensory neuropathy (HMSN) any of a group of hereditary polyneuropathies involving muscle weakness, atrophy, sensory deficits, and vasomotor changes in the lower limbs. Some diseases in this group have been numbered: types I and II are varieties of Charcot-Marie-Tooth disease and type III is neuropathy" >progressive hypertrophic neuropathy.hereditary sensory neuropathy hereditary sensory radicular neuropathy.hereditary sensory and autonomic neuropathy (HSAN) any of several inherited neuropathies that involve slow ascendance of lesions of the sensory nerves, resulting in pain, distal trophic ulcers, and a variety of autonomic disturbances. Types include neuropathy" >hereditary sensory radicular neuropathy and dysautonomia" >familial dysautonomia.hereditary sensory radicular neuropathy a dominantly inherited polyneuropathy characterized by signs of radicular sensory loss in both the upper and lower limbs; shooting pains; chronic, indolent, trophic ulceration of the feet; and sometimes deafness. Called also hereditary sensory neuropathy and Denny-Brown's sensory neuropathy or syndrome" >syndrome.Leber's optic neuropathy a maternally transmitted disorder characterized by bilateral progressive optic atrophy, with onset usually at about the age of twenty. Degeneration of the optic nerve and papillomacular bundle results in progressive loss of central vision that may remit spontaneously. It is much more common in males. Called also Leber's disease and Leber's optic atrophy.progressive hypertrophic neuropathy a slowly progressive familial disease beginning in early life, marked by hyperplasia of interstitial connective tissue, causing thickening of peripheral nerve trunks and posterior roots, and by sclerosis of the posterior columns of the spinal cord, with atrophy of distal parts of the legs and diminution of tendon reflexes and sensation. Called also Dejerine's disease and Dejerine-Sottas disease.serum neuropathy a neurologic disorder, usually involving the cervical nerves or brachial plexus, occurring two to eight days after the injection of foreign protein, as in immunization or serotherapy for tetanus, diphtheria, or scarlet fever, and characterized by local pain followed by sensory disturbances and paralysis. Called also serum neuritis.

en·trap·ment neu·rop·a·thy

a focal nerve lesion produced by constriction or mechanical distortion of the nerve, within a fibrous or fibroosseous tunnel, or by a fibrous band; with these lesions, stretching and angulation of the nerve may be as important a source of injury as compression; entrapment neuropathies tend to occur at particular sites in the body.

entrapment neuropathy

Entrapment syndrome Neurology Any of a group of neuromuscular disorders caused by anatomic restriction or compression, usually of a single peripheral sensorimotor nerve in a bony or fibrous canal–eg, carpal tunnel syndrome, thoracic outlet syndrome, ulnar neuropathy Clinical Pain, especially at night, paresthesias, painful tingling, muscle weakness which, if not relieved, results in atrophy of the innervated muscles Examples Carpal tunnel syndrome, obturator canal syndrome, tarsal tunnel syndrome. See Carpal tunnel syndrome, Peripheral neuropathy, Thoracic outlet syndrome.

en·trap·ment neu·rop·a·thy

(en-trap'mĕnt nūr-op'ă-thē) A focal nerve lesion produced by constriction or mechanical distortion of the nerve, within a fibrous or fibroosseous tunnel, or by a fibrous band.

neuropathy

(noo-rop'a-the) [ neuro- + -pathy] Any disease of the nerves. neuropathic (noor?o-path'ik), adjective See: table; polyneuropathy.

AIDS peripheral neuropathy

Direct infection of peripheral nerves by HIV, resulting in sensory and motor changes due to destruction of axons or their myelin covering. Acute or chronic inflammatory myelin damage may be the first sign of peripheral nerve involvement. Patients display gradual or abrupt onset of motor weakness and diminished or absent reflexes. Diagnostic biopsies of peripheral nerves show inflammatory changes and loss of myelin. Distal sensory neuropathy occurs in up to 30% of patients with AIDS, usually late in the disease. There is increased risk in older patients and those with diabetes mellitus, nutritional deficiencies, low CD4 cell counts, and vitamin B₁₂ deficiencies. Patients report sharp pain, numbness, or burning in the feet. Destruction of dorsal root ganglions and degeneration of central peripheral axons are seen on autopsy. Some older antiretroviral drugs (ddI, ddC, and d4T) also cause a reversible peripheral neuropathy in about 20% of patients. See: AIDS; Guillain-Barré syndrome; chronic inflammatory demyelinating polyneuropathy

Treatment

Nonsteroidal anti-inflammatory drugs, opioids, gabapentin, anticonvulsants, and topical agents have all been used with variable success to treat the pain of AIDS-related sensory neuropathy. Acupuncture is not effective. Human nerve growth factor, which stimulates regeneration of damaged nerve fibers, is being studied, esp. to minimize the neuropathy that antiretroviral drugs cause.

ascending neuropathy

Neuropathy that ascends from the lower part of the body to the upper.

auditory neuropathy

Abbreviation: AN
Impaired hearing in children due to an absence of auditory evoked potentials, despite the presence of normal cochlear hair cell structure and function. Synonym: auditory dyssynchrony

descending neuropathy

Neuropathy that descends from the upper part of the body to the lower.

NEUROPATHIC FOOT DUE TO DIABETES

diabetic neuropathy

Damage to autonomic, motor, and/or sensory nerves due to metabolic or vascular derangements in patients with long-standing diabetes mellitus. In Western nations, diabetes is the most common cause of neuropathy. Symptoms usually include loss of sensation or unpleasant sensations in the feet, erectile dysfunction, focal motor deficits, gastroparesis, loss of the ability to maintain postural blood pressure, and diseases of cardiac innervation. Sensory loss in the feet may result in undetected injuries that become infected or gangrenous. Synonym: diabetic polyneuropathy See: illustration

Treatment

Tight control of blood sugar levels may prevent some neuropathic symptoms in patients with diabetes mellitus.

dysthyroid optic neuropathy

Crowding of and damage to the optic nerve in patients with Grave's disease. It is characterized by loss of visual acuity and color vision, swelling of the optic disk, and compression of the optic nerve at the apex of the orbit. Synonym: apical crowding

entrapment neuropathy

Nerve entrapment syndrome.

facial sensory neuropathy

Trigeminal neuralgia.

focal neuropathy

Any nerve disease or injury, e.g., carpal tunnel syndrome or peroneal nerve palsy, that affects a single nerve.

generalized neuropathy

A rarely used synonym for polyneuropathy.

glue-sniffer's neuropathy

Malfunction of sensory and motor nerves due to inhaling toxic hydrocarbons. The lower extremities and trigeminal nerve are most often damaged.

interdigital neuropathy

See: Morton, Thomas George

multifocal motor neuropathy

An asymmetrical motor weakness occasionally found in middle-aged men.

optic neuropathy

Pathological injury to the optic nerves or the blood supply to them. Usually, only one eye is affected. Several forms have been described, including ischemic optic neuropathy, which, if prolonged, leads to blindness in the affected eye; optic neuritis due to acute demyelination of optic nerve fibers; infiltrative optic neuropathy, in which the optic nerve is compressed by a tumor or aneurysm; and optic neuropathy due to toxic nutritional factors, e.g., methanol or a combined nutritional and vitamin deficiency.

peripheral neuropathy

Any syndrome in which muscle weakness, paresthesias, impaired reflexes, and autonomic symptoms in the hands and feet are common. This syndrome occurs in patients with diabetes mellitus, renal or hepatic failure, alcoholism, or in those who take certain medications such as phenytoin and isoniazid.

plantar neuropathy

Any of several conditions in which nerves that supply sensation to the sole of the foot are injured or chronically compressed, resulting in burning and tingling sensations and difficulty standing, walking, or running.

subacute myelo-optic neuropathy

, subacute myelo-optico neuropathy Abbreviation: SMON
Neuropathy that usually begins with abdominal pain or diarrhea, followed by sensory and motor disturbances in the lower limbs, ataxia, impaired vision, and convulsions or coma. It is reported mostly in Japan and Australia. Most patients survive, but neurological disability remains. Many of those who have the disease have a history of taking drugs of the halogenated oxyquinoline group such as clioquinol (formerly called iodochlorhydroxyquin).

sural neuropathy

A relatively rare form of sensory neuropathy affecting the lateral ankle, typically associated with the wearing of poorly fitting work boots or shoes that compress the sural nerve.

tomaculous neuropathy

The presence of sausage-shaped areas of thickened myelin with secondary axon constriction in some cases of familial recurrent brachial neuropathy.

toxic-nutritional optic neuropathy

Bilateral visual impairment with central scotomas. This is usually associated with a toxic or nutritional disorder (e.g., the ingestion of methyl alcohol).

vibration-induced neuropathy

Hand-arm vibration syndrome.

Name	Affected nerve(s)	Affected part(s)	Affects sensation?	Affects movement?	Clinical features	Type of neuropathy
Bell’s palsy	Facial	Eye, nasolabial fold, lip (corner of the mouth)	Occasionally	Yes	Paralysis of the facial muscles, usually on just one side of the face	Inflammatory
Carpal tunnel syndrome	Median	Wrist and hand	Yes	Yes	Pain and numbness of the hand and wrist, often caused by repetitive movements or overuse such as typing, sawing, hammering, or polishing	Entrapment
Diabetic sensory neuropathy	Multiple	Feet, lower extremities; sometimes hands late in the course	Yes	No	Burning, stinging pain beginning in both feet, typically occurring after several years of poorly controlled diabetes. Can predispose to foot injury and infections.	Metabolic
Idiopathic brachial plexopathy (neuralgic amyotrophy; Parsonage-Turner syndrome; shoulder girdle syndrome)	Brachial	Shoulder	Yes	Yes	Pain in the shoulder, esp. after vigorous physical activity. Occasionally followed by shoulder girdle muscle atrophy	Entrapment
Meralgia paresthetica	Lateral femoral cutaneous	Thigh	Yes	No	Stinging pain in the anterolateral thigh. Usually found in obesity or in diabetes mellitus	Entrapment
Morton’s neuroma (interdigital neuropathy)	Interdigital nerves of the feet	Ball of foot	Yes	No	Pain often occurring between the web spaces of the 3rd and 4th toes during walking or standing	Entrapment
Piriformis syndrome	Sciatic	Buttock, with radiation into the leg	Yes	No	Buttock pain without back pain that is worsened by sitting and is relieved by walking	Entrapment/compression
Radial nerve palsy (musculospiral paralysis; Saturday night palsy)	Radial nerve (spiral groove entrapment)	Wrist, hand, and forearm	Yes	Yes	Temporary paralysis and numbness of the hand and arm, which may mimic a stroke. Caused by nerve compression, e.g., falling asleep on one’s side on a hard surface	Entrapment compression
Suprascapular neuropathy	Suprascapular	Back of the shoulder	Yes	Yes	Shoulder pain and muscular atrophy. Decreased ability to rotate or abduct the shoulder	Entrapment
Tarsal tunnel syndrome	Posterior tibial	Sole of the foot	Yes	No	Pain under the foot that is worsened by walking	Entrapment
Trigeminal neuralgia	Trigeminal	Cheek, nose, upper lip	Yes	No	Intense, repetitive facial pains that are often worsened by chewing, shaving, or toothbrushing, usually accompanied by spasm on the affected side of the face	Entrapment

entrapment neuropathy

Disorders of nerves due to mechanical compression when they pass through narrow apertures in the body. This is a common cause of peripheral nerve disorder. See CARPAL TUNNEL SYNDROME and CERVICAL RIB.