Palmaris brevis spasm

Liguori, Rocco; Donadio, Vincenzo; Stasi, Vitantonio Di; Cianchi, C.; Montagna, P.

doi:10.1212/01.wnl.0000064165.70159.93

Cited by 11 publications

(7 citation statements)

References 7 publications

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“…Although the mechanism of the syndrome is unknown, it may be because of the occurrence of ectopic action potentials and ephaptic transmission from injured nerve fibers. Medications such as lidocaine, phenytoin, and carbamazepine have been applied for treatment (Serratrice et al, 1995;Liguori et al, 2003;Davis, 2004). However, botulinum toxin type A is currently regarded as the treatment of choice in patients with disturbing symptoms (Tarsy et al, 2004;Ar anyi and Kov acs, 2015).…”

Section: Discussionmentioning

confidence: 99%

Anatomical insights of the palmaris brevis muscle for clinical procedures of the hand

2017

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The purpose of the present study is to provide useful data for anatomists and clinicians by describing the topography of the palmaris brevis muscle, taking particular note of its morphology and distribution pattern of the nerve and artery. Forty-nine hands from Korean adult cadavers were used in this study. Parameters with respect to the size, scale, and location of the muscle were measured using a ultrasonography system, digital caliper, and surgical microscope. Histologic sections were obtained to clarify the positional relationship with surrounding tissues. The branches of the ulnar nerve and artery, which supply the muscle, were observed. The minimum and maximum depths in which the palmaris brevis muscle can be existed, including the thickness of the skin (1.9 mm), were 3.7 and 6.9 mm, respectively. It was inserted into the hypothenar fascia and the dermis. The main trunk of the ulnar nerve and artery were positioned under the lateral side of the muscle. The richest arborization of perforating branches of the ulnar nerve and artery was mostly confined to the distal section of the lateral side of the muscle. Our findings provide theoretical evidence of the palmaris brevis muscle for clinical procedures of the hand, such as botulinum toxin injection. Clinicians should pay attention not to injure the ulnar artery under the lateral side of the muscle. Botulinum toxin should be injected at a depth of between approximately 2 and 7 mm, considering the range of depth of the muscle. Clin. Anat. 30:397-403, 2017. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Anatomical insights of the palmaris brevis muscle for clinical procedures of the hand

2017

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“…This study examined the PB EMG and muscle architecture during specific movements of the 5th digit and during functional grasping tasks. A few studies have examined single motor unit PB EMG in vivo in healthy participants (Chiou-Tan et al 1998), during clinical examination (Serratrice et al 1995;Liguori et al 2003;Tarsy et al 2004;Eswaradass et al 2014), and its muscle architecture from cadavers (Shrewsbury et al 1972;Przystasz, 1977;Chiou-Tan et al 1998); however, we investigated PB global EMG from a functional perspective and imaged the PB muscle during dynamic contractions using ultrasound. The results indicate that PB EMG activity is under voluntary control and is highly dependent on movements of the 5th digit, and that the PB muscle is capable of significant changes in muscle architecture during voluntary muscle contraction.…”

Section: Discussionmentioning

confidence: 99%

“…Surveying several texts and clinical electromyographic (EMG) investigations of the PB reveals a disparity in the hand movement necessary to evoke its muscle activity. Specific movements of the 5th digit (abduction, flexion, opposition; Serratrice et al 1995;Chiou-Tan et al 1998;Iyer, 1998;Standring, 2008;Perotto et al 2011) or applying mechanical pressure superficial to the pisiform bone (Serratrice et al 1995;Liguori et al 2003;Perotto et al 2011) have been described as actions that evoke PB contraction. Furthermore, some PB descriptions from clinical case reports state that the PB is not under voluntary control (Serratrice et al 1995;Iyer, 1998;Eswaradass et al 2014), which may suggest a smooth muscle composition, under a conditioned (Montagu, 1952) or reflexive control (Boynton-Lee, 1888), like those found in other panniculus carnosus derivatives such as the dartos or corrugator cutis ani muscles (Patil, 2013).…”

Section: Introductionmentioning

confidence: 99%

Structural and functional anatomy of the palmaris brevis: grasping for answers

Moore

Rice

2017

Journal of Anatomy

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The palmaris brevis (PB) is a small cutaneous hand muscle that has been described as the most mysterious muscle from a functional and developmental perspective [Kaplan () Kaplan's Functional and Surgical Anatomy of the Hand]. Functionally, the PB is considered to deepen the hollow of the palm and to protect the neurovasculature of the ulnar canal. Although the function of the PB has been inferred from cadaveric observations, the electromyographic (EMG) activity of this muscle has not been explored systematically during specific movements of the hand. The purpose of this study was to record PB intramuscular EMG activity during dynamic grasping tasks, and to quantify the change in PB muscle length (M ) and thickness (M ) incurred during maximal contraction using ultrasound imaging. Intramuscular EMG was recorded from the PB in the dominant hands of 12 healthy participants (11 males, one female; age: 27 ± 4 years) during maximal abduction, flexion and opposition of the 5th digit, and two grasping tasks. Abduction of the 5th digit yielded the greatest EMG activity in most individuals (seven out of 11), and produced significantly less PB EMG activity when compared with grasping a cylindrical-shaped object (P = 0.003) but not a spherical-shaped object (P = 0.130). During maximal abduction of the 5th digit, PB M decreased in both the left (28 ± 11%; P = 0.002) and right (32 ± 5%; P = 0.002) hands. Similarly, a concomitant increase in PB M was observed in the left (68 ± 30%; P = 0.002) and right (85 ± 44%; P = 0.002) hands during the same contraction. These EMG results indicate that the PB is voluntarily activated during prehensile and non-prehensile movements of the hand with significant changes in muscle architecture. The study supports the preservation of the PB in surgical procedures based on its proposed protective role as a muscular barrier to the neurovasculature within the ulnar canal.

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“…Intramuscular electromyography (EMG) is a useful technique to provide insight into the functional specialization of palmar musculature by recording muscle activation patterns during movements. The abductor pollicis longus and brevis are among several palmar muscles that have been investigated using this technique (Vanoudenaarde & Oostendorp, 1995); however, EMG investigations of the PB have been limited to clinical investigations characterizing PB spasm syndrome in patients (Serratrice et al 1995;Iyer, 1998;Liguori et al 2003;Tarsy et al 2004;Eswaradass et al 2014). As an alternative to EMG, functional insight into the contractile and metabolic capabilities of a skeletal muscle can be achieved by characterizing the muscle fiber-type composition by staining for myosin heavy chain (MHC) isoforms of constituent muscle fibers using immunohistochemical methods.…”

Section: Introductionmentioning

confidence: 99%

Fiber type composition of the palmaris brevis muscle: implications for palmar function

2017

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The palmaris brevis (PB) is a small muscle of variant morphology located on the ulnar aspect of the palm, superficial to the hypothenar eminence. Functionally, the PB has been proposed to protect the neurovasculature of the ulnar canal from compressive forces during repetitive or intermittent trauma associated with grasping. Although PB function has been inferred from cadaveric observations, it is unknown whether it has the contractile capacity and fatigue-resistance necessary to withstand these functional demands. Insight into the functional specialization of the PB can be provided through investigating the proportions of type I and type II muscle fibers by staining for myosin heavy chain (MHC) isoforms using immunohistochemical methods. Therefore, the purpose of this study was to quantify the proportion of type I and type II muscle fibers to provide insight into the role of the PB in palmar function based on its gross histological structure. Sixteen PB specimens were harvested from the hands (eight right, eight left) of eight formalin-embalmed cadavers (mean age: 75 ± 14 years; three males, five females). PB muscle composition was determined by labeling serial cross-sections with MHC type I and type II monoclonal antibodies. The results indicate that the PB is primarily composed of type I muscle fibers (72.2 ± 13.7%), with no significant differences between left and right hands. Given the predominance of type I muscle fibers, our findings indicate the PB may be fatigue-resistant and thus, capable of contracting for prolonged durations. This supports cadaveric observations indicating that the PB functions to protect the ulnar neurovasculature of the palm by providing a muscular barrier in addition to serving as a functional anchor to the hypothenar fat pad when objects are firmly compressed into the palm.

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Palmaris brevis spasm

Cited by 11 publications

References 7 publications

Anatomical insights of the palmaris brevis muscle for clinical procedures of the hand

Anatomical insights of the palmaris brevis muscle for clinical procedures of the hand

Structural and functional anatomy of the palmaris brevis: grasping for answers

Fiber type composition of the palmaris brevis muscle: implications for palmar function

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