The characteristic EDX features of TN-TOS are T1 > C8 nerve fiber involvement. A comprehensive EDX examination of the lower plexus with contralateral comparison studies is imperative to diagnose this disorder accurately.
The authors reviewed the medical records of 33 patients diagnosed with idiopathic phrenic neuropathy and found that 17 patients had clinical features of neuralgic amyotrophy. They concluded that a careful clinical and electrodiagnostic evaluation may implicate neuralgic amyotrophy as a causative disease in patients with apparently isolated phrenic neuropathy.
To identify the segmental innervation of L-2-S-1 muscles, we compared the preoperative electrodiagnostic examinations of 45 patients with single-level lumbosacral radiculopathies confirmed radiologically and surgically. The electrodiagnostic findings were classified as abnormal only by the needle examination and only if muscles demonstrated active denervation or a marked neurogenic motor unit potential firing pattern. In comparison to other surgical, intraoperative root stimulation, and clinical studies, we found several differences. Overall, there was little overlap among L-2-4, L-5, and S-1 radiculopathies. The tibialis anterior was predominantly L-5 innervated, the gastrocnemius (medial and lateral head) predominantly S-1 innervated, and the biceps femoris (short and long head) exclusively S-1 innervated. The two heads of biceps femoris were not affected in any patients with L-5 radiculopathy in whom they were examined. These findings help guide both the clinician and surgeon in the diagnosis and treatment of lumbosacral radiculopathies.
Infraclavicular brachial plexopathy is a potential complication of axillary regional block. We retrospectively reviewed 13 such injuries and found the median nerve most often affected, followed by combined median and ulnar neuropathies, and then by various combinations involving the median, ulnar, radial, and musculocutaneous nerves. All were axon-loss in type and most were severe in degree electrophysiologically. The clinical and electrodiagnostic features of these injuries are strikingly similar to those sustained after axillary arteriography, which has been associated with the medial brachial fascial compartment (MBFC) syndrome. This syndrome is characterized by the evolution of neurologic deficits and pain following hematoma formation within a compartment of the upper arm. Thus, we believe that this mechanism underlies most nerve injuries that result from axillary angiography or axillary regional block. This has important treatment implications, as timely surgical intervention may lead to improved outcome.
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