Traumatic peripheral nerve injuries: diagnosis and management

Barnes, Stephanie L.; Miller, Thomas A.; Simon, Neil

doi:10.1097/wco.0000000000001116

Cited by 17 publications

(11 citation statements)

References 116 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…axonal or demyelination, and prognosis depending nature of injury. 11,12,14 There are few limitations of our study as single center study with small sample size. No follow up EDX was not done and nature of medications given via injection route was not inquired.…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Clinical spectrum, risk factors and electrophysiologic aspect of radial nerve injury

Kanwal

Bano

Ullah³

et al. 2023

PJNS

View full text Add to dashboard Cite

Background and objective: Radial nerve is injured due to a variety of reasons. The objective of this study was to determine the clinical spectrum, risk factors and electrophysiologic aspect of radial nerve injury presenting to a tertiary care hospital in Lahore. Methods: This descriptive prospective cross-sectional study was conducted at department of Neurology, Mayo hospital Lahore from July 2022 to December 2022 and comprised patients with isolated radial nerve injury on the basis of history and clinical examination regardless of their gender, above 15 years of age. NCS/EMG was done on a Japanese machine Nihon Kohden by an expert as per recommended protocol for electrodiagnostic evaluation of a suspected radial nerve injury and interpreted by consultant neurologist. Results: Of 75 patients, 52(69.3%) were males and 23(30.7%) were females. The most common etiology turned out to be misplaced intramuscular injection in 45(60%) of the patients. The site of lesion in most cases was in the spiral groove in 36 (40%) of the patient. Most of the patients i.e. 71(94.7%) had a wrist drop. Evidence of reinnervation was present in 30(40%) of patients. Conclusion: Most cases of radial nerve injury presented with a wrist drop in which the commonest etiology was misplaced intramuscular injection. The site of lesion in most cases turned out to at the level of spiral groove, and the nature of lesion was primarily axonal loss followed by secondary demyelination.

show abstract

Section: Discussionmentioning

confidence: 95%

“…This result is similar to other studies. [11][12][13] EDX studies help in localization, determine the pattern of peripheral nerve injuries i.e. axonal or demyelination, and prognosis depending nature of injury.…”

Section: Discussionmentioning

confidence: 99%

Clinical spectrum, risk factors and electrophysiologic aspect of radial nerve injury

Kanwal

Bano

Ullah³

et al. 2023

PJNS

View full text Add to dashboard Cite

show abstract

“…Often, the decision-making is more complex than in the aforementioned clinical scenarios. For instance, in cases of axonotmesis with axonal continuity to the target organ evidenced by 1–2 motor units on EMG or present but markedly reduced amplitude motor or sensory responses on NCS, the optimal management strategy may involve serial electrodiagnostic assessments every 1–3 months to monitor nerve recovery ( 44 ). This close follow-up permits monitoring of the trajectory of nerve recovery clinically and electrodiagnostically to increase confidence in the likelihood of satisfactory spontaneous recovery or the need for surgical intervention ( 45 ).…”

Section: Pre-operative Electrodiagnostic Assessmentmentioning

confidence: 99%

Assessment, patient selection, and rehabilitation of nerve transfers

Bateman,

Larocerie-Salgado,

Ross

et al. 2023

Front. Rehabil. Sci.

Self Cite

View full text Add to dashboard Cite

Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases. There are two principal advantages of nerve transfers: (1) their ability to shorten the time to reinnervation of muscles undergoing denervation because of peripheral nerve injury; and (2) their specificity in ensuring proximal motor and sensory axons are directed towards appropriate motor and sensory targets. Compared to conventional nerve grafting, nerve transfers offer opportunities to reinnervate muscles affected by cervical spinal cord injury and to augment natural reinnervation potential for very proximal injuries. This article provides a narrative review of the current scientific knowledge and clinical understanding of nerve transfers including peripheral nerve injury assessment and pre- and post-operative electrodiagnostic testing, adjuvant therapies, and post-operative rehabilitation for optimizing nerve transfer outcomes.

show abstract

“…Current diagnosis of PNI relies mainly on clinical symptoms caused by peripheral nervous system (PNS) dysfunction, which is often at an advanced stage by the time they appear. Besides, clinical methods, including muscle strength testing, electromyography and intraoperative electrophysiological examination, are commonly used for detecting the axonal regeneration and evaluating the functional recovery of peripheral nerve [ 3 , 4 ]. However, the lack of timeliness, objectivity, accuracy and visualization is believed to be the major limitation of these methods.…”

Section: Introductionmentioning

confidence: 99%