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1.
Medicine (Baltimore) ; 98(50): e18327, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852126

RESUMO

BACKGROUND: Acupotomy has been widely used to treat nerve entrapment syndrome. But its efficiency has not been scientifically and methodically evaluated. The aim of this study is to evaluate the efficacy and safety of the acupotomy treatment in patients with nerve entrapment syndrome. METHODS: Fifteen databases will be searched from inception to Dec 2019. We will include randomized controlled trials (RCTs) assessing acupotomy for nerve entrapment syndrome. All RCTs on acupotomy or related interventions will be included. Study inclusion, data extraction and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be performed using RevMan 5.3 software. Cochrane criteria for risk-of-bias will be used to assess the methodological quality of the trials. RESULTS: This study will provide a high-quality synthesis of pain VAS and functional disability or the quality of life, the success treatment rate, the recurrent rate and the complications rate to assess the effectiveness and safety of acupotomy for nerve entrapment syndrome patients. CONCLUSION: This systematic review will provide evidence to judge whether acupotomy is an effective intervention for patients with nerve entrapment syndrome. PROSPERO REGISTRATION NUMBER: CRD42018109086.


Assuntos
Terapia por Acupuntura/métodos , Síndromes de Compressão Nervosa/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Síndrome , Revisão Sistemática como Assunto , Resultado do Tratamento
2.
Unfallchirurg ; 122(11): 854-859, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31712850

RESUMO

Young individuals with chronic exercise-induced lower leg pain (ELP) who have normal compartmental muscle pressures and normal imaging occasionally suffer from a nerve entrapment syndrome. These patients have consistently undergone a variety of diagnostic tests and often futile therapies prior to arriving at the correct diagnosis. Awareness among traumatologists regarding these nerve entities is low. A lower leg discomfort that is frequently present at night but worsens during exercise combined with altered foot skin sensations suggests an entrapment of the common peroneal or tibial nerve. If conservative therapies fail, neurolysis is advised.


Assuntos
Dor Crônica/etiologia , Síndromes de Compressão Nervosa/diagnóstico , Nervo Fibular , Nervo Tibial , Exercício , Pé/inervação , Humanos , Perna (Membro)/inervação , Síndromes de Compressão Nervosa/complicações , Síndromes de Compressão Nervosa/terapia
3.
J Headache Pain ; 20(1): 76, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266456

RESUMO

Unremitting head and neck pain (UHNP) is a commonly encountered phenomenon in Headache Medicine and may be seen in the setting of many well-defined headache types. The prevalence of UHNP is not clear, and establishing the presence of UHNP may require careful questioning at repeated patient visits. The cause of UHNP in some patients may be compression of the lesser and greater occipital nerves by the posterior cervical muscles and their fascial attachments at the occipital ridge with subsequent local perineural inflammation. The resulting pain is typically in the sub-occipital and occipital location, and, via anatomic connections between extracranial and intracranial nerves, may radiate frontally to trigeminal-innervated areas of the head. Migraine-like features of photophobia and nausea may occur with frontal radiation. Occipital allodynia is common, as is spasm of the cervical muscles. Patients with UHNP may comprise a subgroup of Chronic Migraine, as well as of Chronic Tension-Type Headache, New Daily Persistent Headache and Cervicogenic Headache. Centrally acting membrane-stabilizing agents, which are often ineffective for CM, are similarly generally ineffective for UHNP. Extracranially-directed treatments such as occipital nerve blocks, cervical trigger point injections, botulinum toxin and monoclonal antibodies directed at calcitonin gene related peptide, which act primarily in the periphery, may provide more substantial relief for UHNP; additionally, decompression of the occipital nerves from muscular and fascial compression is effective for some patients, and may result in enduring pain relief. Further study is needed to determine the prevalence of UHNP, and to understand the role of occipital nerve compression in UHNP and of occipital nerve decompression surgery in chronic head and neck pain.


Assuntos
Transtornos da Cefaleia/etiologia , Cervicalgia/etiologia , Síndromes de Compressão Nervosa/complicações , Transtornos da Cefaleia/terapia , Humanos , Cervicalgia/terapia , Bloqueio Nervoso/métodos , Síndromes de Compressão Nervosa/terapia , Nervos Espinhais
4.
BMJ Case Rep ; 12(5)2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31092495

RESUMO

This is a rare case of an anterior interosseous nerve (AIN) palsy in a patient as a result of a prolonged period of shoulder immobilisation. The patient had an open reduction internal fixation of a midshaft clavicle fracture. They subsequently underwent removal of metal due to symptomatic prominence of the metal work. The patient was in a shoulder immobiliser for a period of 5 months in total. They developed progressive AIN palsy as a result of a positional compression due to prolonged wearing of a shoulder immobiliser. This resolved with conservative management and careful observation.


Assuntos
Imobilização/efeitos adversos , Síndromes de Compressão Nervosa/etiologia , Articulação do Ombro/inervação , Clavícula/lesões , Tratamento Conservador , Humanos , Masculino , Síndromes de Compressão Nervosa/terapia , Redução Aberta/efeitos adversos , Adulto Jovem
5.
Clin Plast Surg ; 46(3): 285-293, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31103073

RESUMO

Nerve compression occurs in fibro-osseous tunnels as the nerves cross joints. The pathology involves traction and adhesion, aside from compression. This can occur at multiple sites along the course of the nerve. Regardless of level, clinical assessment is standard and a systematic approach to uncover all sites of compression is advised. Evolution of management for carpal tunnel and cubital tunnel syndrome is reviewed with an emphasis on natural history and nonsurgical treatment, which are not commonly discussed. Treatment is multimodal and the systemic factors that contribute to nerve dysfunction should also be addressed.


Assuntos
Síndromes de Compressão Nervosa , Síndrome do Túnel Carpal/terapia , Síndrome do Túnel Ulnar/terapia , Humanos , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/fisiopatologia , Síndromes de Compressão Nervosa/terapia
6.
J Bone Joint Surg Am ; 101(6): 523-530, 2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-30893233

RESUMO

BACKGROUND: Peripheral nerve compression and entrapment can be debilitating. Using a validated animal model of peripheral nerve compression, we examined the utility of 2 drugs approved for other uses in humans, 4-aminopyridine (4-AP) and erythropoietin (EPO), as treatments for surgically induced ischemia and as adjuvants to surgical decompression. METHODS: Peripheral nerve compression was induced in wild-type mice by placing an inert silicone sleeve around the sciatic nerve. Decompression surgery was performed at 6 weeks with mice receiving 4-AP, EPO, or saline solution either during and after compression or only after decompression. A nerve conduction study and morphometric analyses were performed to compare the extent of the injury and the efficacy of the therapies, and the findings were subjected to statistical analysis. RESULTS: During peripheral nerve compression, there was a progressive decline in nerve conduction velocity compared with that in sham-treatment animals, in which nerve conduction velocity remained normal (∼55 m/s). Mice treated with 4-AP or EPO during the compression phase had significantly smaller declines in nerve conduction velocity and increased plateau nerve conduction velocities compared with untreated controls (animals that received saline solution). Histomorphometric analyses of newly decompressed nerves (i.e., nerves that underwent decompression on the day that the mouse was sacrificed) revealed that both treated groups had significantly greater proportions of large (>5-µm) axons than the untreated controls. Following surgical decompression, all animals recovered to a normal baseline nerve conduction velocity by day 15; however, treatment significantly accelerated improvement (in both the 4-AP and the EPO group), even when it was only started after decompression. Histomorphometric analyses at 7 and 15 days following surgical decompression revealed significantly increased myelin thickness and significantly greater proportions of large axons among the treated animals. CONCLUSIONS: Both the 4-AP and the EPO-treated group demonstrated improvements in tissue architectural and electrodiagnostic measurements, both during and after peripheral nerve compression, compared with untreated mice. CLINICAL RELEVANCE: Peripheral nerve decompression is one of the most commonly performed procedures in orthopaedic surgery. We believe that there is reason for some optimism about the translation of our findings to the clinical setting. Our findings in this murine model suggest that 4-AP and EPO may lessen the effects of nerve entrapment and that the use of these agents after decompression may speed and perhaps otherwise optimize recovery after surgery.


Assuntos
4-Aminopiridina/uso terapêutico , Epoetina alfa/uso terapêutico , Hematínicos/uso terapêutico , Síndromes de Compressão Nervosa/terapia , Bloqueadores dos Canais de Potássio/uso terapêutico , Neuropatia Ciática/terapia , Animais , Descompressão Cirúrgica , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Síndromes de Compressão Nervosa/fisiopatologia , Condução Nervosa/fisiologia , Neuropatia Ciática/fisiopatologia
7.
Dtsch Arztebl Int ; 116(4): 54-60, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30855007

RESUMO

BACKGROUND: Nerve compression syndromes in the posterior cranial fossa can severely impair patients' quality of life. There is often uncertainty about the best treatment. In this article, we provide an overview of these conditions and the corresponding treatment strategies. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed and on a scientific analysis of the authors' patient collective. RESULTS: These syndromes are caused by compression of a cranial nerve by an artery or vein at the zone of the nerve's entry to or exit from the brainstem. The best-known neurovascular compression syndrome is trigeminal neuralgia, followed by hemifacial spasm. Less well known are glossopharyngeal neuralgia, nervus intermedius neuralgia, and vestibular paroxysmia. The initial treatment of trigeminal neuralgia is medical: the first line of treatment is with sodium-blocking anticon- vulsants, such as carbamazepine. For patients with hemifacial spasm, botulinum toxin injection is the recommended initial treatment and often leads to a satisfactory regression of the spasms. If these treatments fail, a microvascular decompression operation is indicated. The aim of the procedure is to separate the irritating vessel from the nerve and to keep these structures apart permanently. There is hardly any available evidence on these treatment strategies from randomized controlled trials. CONCLUSION: Nerve compression syndromes in the posterior cranial fossa can generally be treated nonsurgically at first. Over the course of the condition, however, treatment failure or intolerable side effects may arise. In such cases, a microvascu- lar decompression operation is indicated. This is a causally directed form of treat- ment that generally yields very good results.


Assuntos
Síndromes de Compressão Nervosa/terapia , Fossa Craniana Posterior , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Med Clin North Am ; 103(2): 357-370, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30704687

RESUMO

Upper extremity entrapment neuropathies are common and can cause pain, sensory loss, and muscle weakness that lead to functional disability. In this article, the authors review common entrapment neuropathies of the upper extremities, including median neuropathy at the wrist (carpal tunnel syndrome), ulnar neuropathy at the elbow, and radial neuropathy. The authors discuss the pathophysiology of nerve compression and typical etiologies, as well as strategies for differentiating between common mimics such as cervical radiculopathy and for selecting between various treatment modalities.


Assuntos
Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/terapia , Exame Neurológico , Síndrome do Túnel Carpal/diagnóstico , Diagnóstico Diferencial , Eletrodiagnóstico , Humanos , Síndromes de Compressão Nervosa/fisiopatologia , Paralisia/diagnóstico , Paralisia/terapia , Extremidade Superior
9.
Med Clin North Am ; 103(2): 371-382, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30704688

RESUMO

Entrapment neuropathies in the lower limbs are a common neurologic problem and may present in any medical setting. Accurate identification and management of these nerve palsies can prevent pain, sensory loss, incoordination, and muscle weakness that may significantly affect a patient's functional mobility. In this article, the authors focus on the cause, signs and symptoms, diagnosis, and treatment of select entrapment neuropathies of the lower extremity, including palsies of the common peroneal, lateral femoral cutaneous, femoral, and posterior tibial nerves.


Assuntos
Síndromes de Compressão Nervosa/diagnóstico , Exame Neurológico , Diagnóstico Diferencial , Eletrodiagnóstico , Humanos , Extremidade Inferior , Síndromes de Compressão Nervosa/terapia , Ultrassonografia
10.
J Hand Surg Eur Vol ; 44(3): 310-316, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30509150

RESUMO

Isolated posterior interosseous nerve palsy is an uncommon condition and its management is controversial. Existing literature is sparse and a treatment algorithm based on existing best evidence is absent. A comprehensive review was undertaken to elucidate the causes of spontaneous posterior interosseous nerve palsy and suggest a management strategy based on the current evidence. Posterior interosseous nerve palsy can be broadly categorized as compressive and non-compressive, and the existing evidence supports surgical intervention for compressive palsy. For posterior interosseous nerve pathology with no compressive lesion on imaging, conservative management should be tried first. Surgery is therefore reserved for compressive lesions and for failure of conservative management. The commonly performed operative procedures include decompression and neurolysis, neurorrhaphy and nerve grafting, and tendon transfers with or without nerve grafting performed as a salvage procedure. The prognosis is poorer in patients aged > 50 years, those with a delay to surgery, and those who have had long-standing compression with severe fascicular thinning.


Assuntos
Neuropatia Radial/etiologia , Neuropatia Radial/terapia , Algoritmos , Neurite do Plexo Braquial/complicações , Neurite do Plexo Braquial/terapia , Constrição Patológica/complicações , Constrição Patológica/terapia , Descompressão Cirúrgica , Diagnóstico Diferencial , Fáscia/patologia , Humanos , Bloqueio Nervoso , Síndromes de Compressão Nervosa/complicações , Síndromes de Compressão Nervosa/terapia , Neuropatia Radial/classificação , Neuropatia Radial/diagnóstico
11.
Phys Sportsmed ; 47(1): 47-59, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30345867

RESUMO

The purpose of this review is to describe and critically evaluate current knowledge regarding diagnosis, assessment, and management of chronic overload leg injuries which are often non-specific and misleadingly referred to as 'shin splints'. We aimed to review clinical entities that come under the umbrella term 'Exercise-induced leg pain' (EILP) based on current literature and systematically searched the literature. Specifically, systematic reviews were included. Our analyses demonstrated that current knowledge on EILP is based on a low level of evidence. EILP has to be subdivided into those with pain from bone stress injuries, pain of osteo-fascial origin, pain of muscular origin, pain due to nerve compression and pain due to a temporary vascular compromise. The history is most important. Questions include the onset of symptoms, whether worse with activity, at rest or at night? What exacerbates it and what relieves it? Is the sleep disturbed? Investigations merely confirm the clinical diagnosis and/or differential diagnosis; they should not be solely relied upon. The mainstay of diagnosing bone stress injury is MRI scan. Treatment is based on unloading strategies. A standard for confirming chronic exertional compartment syndrome (CECS) is the dynamic intra-compartmental pressure study performed with specific exercises that provoke the symptoms. Surgery provides the best outcome. Medial tibial stress syndrome (MTSS) presents a challenge in both diagnosis and treatment especially where there is a substantial overlap of symptoms with deep posterior CECS. Conservative therapy should initially aim to correct functional, gait, and biomechanical overload factors. Surgery should be considered in recalcitrant cases. MRI and MR angiography are the primary investigative tools for functional popliteal artery entrapment syndrome and when confirmed, surgery provides the most satisfactory outcome. Nerve compression is induced by various factors, e.g., localized fascial entrapment, unstable proximal tibiofibular joint (intrinsic) or secondary by external compromise of the nerve, e.g., tight hosiery (extrinsic). Conservative is the treatment of choice. The localized fasciotomy is reserved for recalcitrant cases.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Traumatismos da Perna/diagnóstico , Traumatismos da Perna/terapia , Dor/etiologia , Síndrome do Compartimento Anterior/complicações , Síndrome do Compartimento Anterior/diagnóstico , Síndrome do Compartimento Anterior/terapia , Atletas , Traumatismos em Atletas/complicações , Síndromes Compartimentais/diagnóstico , Síndromes Compartimentais/cirurgia , Síndromes Compartimentais/terapia , Tratamento Conservador , Diagnóstico Diferencial , Exercício/fisiologia , Fasciotomia , Fraturas de Estresse/complicações , Fraturas de Estresse/diagnóstico , Fraturas de Estresse/terapia , Humanos , Traumatismos da Perna/complicações , Masculino , Síndromes de Compressão Nervosa/complicações , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/terapia , Dor/diagnóstico , Fraturas da Tíbia/complicações , Fraturas da Tíbia/diagnóstico , Fraturas da Tíbia/terapia
12.
A A Pract ; 12(10): 352-355, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-30371523

RESUMO

Middle cluneal nerve entrapment neuropathy/neuralgia (MCN-EN) is a rare and potentially underdiagnosed etiology for chronic low back pain. Symptoms include pain in the buttock and posterior superior iliac spine area that is increased by activity and direct pressure over the area, and is "neuropathic" in nature. Previous case reports describe successful treatment of MCN-EN with nerve block and/or surgical decompression of the MCN. We present a case report detailing the first successful use of radiofrequency nerve ablation in treating MCN-EN.


Assuntos
Bloqueio Nervoso/métodos , Síndromes de Compressão Nervosa/terapia , Idoso , Feminino , Humanos , Ablação por Radiofrequência , Resultado do Tratamento
14.
Disabil Rehabil ; 41(8): 991-993, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29216768

RESUMO

PURPOSE: To describe the clinical manifestation and the treatment of complex regional pain syndrome type II in childhood. METHODS: Using information on the symptoms, diagnosis, rehabilitation and outcome of a young patient with complex regional pain syndrome type II. RESULTS: A 9-year -old girl had severe pain in the region of the left foot, signs of a common fibular nerve entrapment, hyperalgesia not limited to the distribution of the injured nerve, weakness and temperature asymmetry unknown origin. She consulted few doctor's before she was given the right diagnosis of complex regional pain syndrome type II. Following the diagnosis the treatment started, it included intensive physiotherapy, electrical therapy and also supportive psychological therapy. Half a year later, the patient was free of the daily pain and returned to all physical activity without any restrictions. CONCLUSIONS: The case report illustrates that peripheral nerve compression or injuries specifically, complex regional pain syndrome type II, should be taken into consideration when evaluating children with weakness and pain of the lower or upper limb. Implication of rehabilitation Raising the awareness of complex regional pain syndrome in the childhood is essential for an early diagnosis and appropriate treatment. The treatment options include early and adequate pain management inclusive electrical therapy and physiotherapy. Psychological therapy helps to avoid psychological stress reaction and the disease negative impact on the child's education and sports and the family social life.


Assuntos
Síndromes da Dor Regional Complexa , Terapia por Estimulação Elétrica/métodos , , Modalidades de Fisioterapia , Técnicas Psicológicas , Criança , Síndromes da Dor Regional Complexa/diagnóstico , Síndromes da Dor Regional Complexa/fisiopatologia , Síndromes da Dor Regional Complexa/psicologia , Síndromes da Dor Regional Complexa/reabilitação , Exercício , Feminino , Pé/inervação , Pé/fisiopatologia , Humanos , Hiperalgesia/diagnóstico , Hiperalgesia/etiologia , Hiperalgesia/terapia , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/fisiopatologia , Síndromes de Compressão Nervosa/terapia , Medição da Dor/métodos , Resultado do Tratamento
15.
Zh Nevrol Psikhiatr Im S S Korsakova ; 118(10): 122-127, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30499508

RESUMO

The article discusses such a common pathology as pain syndrome in the lower back and limbs. A variety of etiological causes, anatomical features leading to the formation of this persistent algic disorder lead to therapeutic failures in clinical practice. The authors consider in detail the most common types of compression-ischemic neuropathy accompanying back pain, suggest diagnostic algorithms and practical recommendations. Results of foreign, Russian and own research are presented.


Assuntos
Dor Lombar , Síndromes de Compressão Nervosa , Doenças do Sistema Nervoso Periférico , Dor nas Costas , Dor Lombar/diagnóstico , Dor Lombar/reabilitação , Dor Lombar/terapia , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/reabilitação , Síndromes de Compressão Nervosa/terapia , Federação Russa
16.
Rozhl Chir ; 97(6): 286-290, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30442009

RESUMO

Meralgia paresthetica is a compression neuropathy of the lateral femoral cutaneous nerve. Despite its rarity, it is the most common nerve entrapment of the lower limbs. It produces similar symptoms as those associated with the more common L4 or L5 radiculopathy. Therefore, it is often diagnosed late (sometimes only after several years of latency) or not at all. This diagnosis should be considered especially in patients with obesity and diabetes who have chronic irritation of the ventrolateral areas of the thigh not responding to conservative therapy and a negative finding on lumbar MRI. We present our experience with surgical nerve decompression in three patients with pain, paresthesias, and sensory loss within the distribution of the lateral cutaneous nerve of the thigh. They all suffered from severe abdominal obesity. All conservative treatments, including weight reduction attempts, were unsuccessful. Nerve release caused an immediate effect in two cases. One patient experienced a temporary worsening of pain, which gradually improved within one month. In spite of the controversy surrounding the surgical treatment of meralgia (neurolysis or nerve resection), it can be concluded that nerve decompression has a good effect. Nerve resection is, in our view, considered to be a reserve option when primary surgery fails. Key words: meralgia paresthetica - nerve entrapment - peripheral nerve.


Assuntos
Neuropatia Femoral , Síndromes de Compressão Nervosa , Neuropatia Femoral/diagnóstico , Neuropatia Femoral/terapia , Humanos , Plexo Lombossacral , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/terapia , Parestesia , Coxa da Perna
17.
Einstein (Sao Paulo) ; 16(3): eAO4206, 2018 Sep 17.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30231143

RESUMO

OBJECTIVE: To evaluate the effects of right sciatic nerve compression and cryotherapy on muscle tissue. METHODS: We used 42 male Wistar rats, subdivided in the following Groups Control, Injury 3, Injury 8 and Injury 15 submitted to nerve compression and euthanized in the 3rd, 8th and 15th day after surgery. The Cryotherapy Injury 3 was entailed treatment with cryotherapy by immersion of the animal in recipient for 20 minutes during 1 day, then animals were euthanized at the 3rd day after surgery, and the Cryotherapy Injury 8 and the Cryotherapy Injury 15 was treated for 6 days, and euthanized at the 8th and 15th day after surgery. Functional evaluation was performed by the grasping strength of the right pelvic limb. The right tibialis anterior muscles were evaluated for mass, smaller diameter and cross-sectional area. In the Cryotherapy Injury 8 and the Cryotherapy Injury 15 groups, the hydroxyproline was dosed in the right soles. RESULTS: In the compression there was a significant difference in the Injury Groups compared with the Control Group (p<0.05). In the smaller diameter, the compression in Control Group was higher than Injury 8 (p=0.0094), Injury 15 (p=0.002) and Cryotherapy Injury 15 (p<0.001) groups. The comparison between groups with euthanasia in the same post-operative period, a significant difference (p=0.0363) was seen in day 8th after surgery, and this result in Cryotherapy Injury Group was greater than Injury Group. In the fiber area, Control Group was also higher than the Injury 8 (p=0.0018), the Injury 15 (p<0.001) and the Cryotherapy Injury 15 (p<0.001). In hydroxyproline, no significant difference was seen between groups. CONCLUSION: Nerve damage resulted in decreased muscle strength and trophism, the cryotherapy delayed hypotrophy, but this effect did not persist after cessation of treatment.


Assuntos
Crioterapia/métodos , Síndromes de Compressão Nervosa/patologia , Síndromes de Compressão Nervosa/terapia , Nervo Isquiático/patologia , Neuropatia Ciática/patologia , Neuropatia Ciática/terapia , Animais , Modelos Animais de Doenças , Hipertrofia/fisiopatologia , Masculino , Debilidade Muscular/fisiopatologia , Síndromes de Compressão Nervosa/fisiopatologia , Distribuição Aleatória , Ratos Wistar , Valores de Referência , Reprodutibilidade dos Testes , Nervo Isquiático/fisiopatologia , Nervo Isquiático/cirurgia , Neuropatia Ciática/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
18.
Neurol Res ; 40(11): 955-962, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30091393

RESUMO

OBJECTIVE: This study aims to investigate morphological alterations caused by partial sciatic nerve ligation (PNL) and the efficacy of a moderate-intensity swimming training as therapeutic strategy for nerve regeneration. METHODS: A number of 30 male adult mice were equally divided in control, 14 days after PNL (PNL 14 days), 42 days after PNL (PNL 42 days), 70 days after PNL (PNL 70 days) and 5-week exercise training after 7 days post-lesion (PNL trained 35 days) groups. PNL trained 35 days group began with a 10-min session for 3 days and this time was gradually increased by 10 min every three sessions until the animals had swum for 50 min per session. Morphoquantitative analysis was carried out to assess nerve regeneration in each group. RESULTS: PNL 14 days group exhibited less degenerating signs than PNL 42 days group, where most post-lesion alterations were visualized. Nerve area and minimum diameter were significantly lower (p < 0.05) than control group. PNL 70 days group showed a greater degree of regenerating fibers and similar morphometric parameters to control group. PNL trained 35 days demonstrated signs of regeneration, reaching control group values in the morphometric analysis. DISCUSSION: PNL promotes great histopathological changes, which became more visible at 42 post-injury days. A natural nerve-regeneration tendency was observed throughout time, as observed in PNL 70 days group; nevertheless, moderate swimming training was found to be a therapeutic resource for nerve regeneration, accelerating such process from a morphoquantitative perspective. ABBREVIATIONS: ANOVA: One-way analysis of variance; BDNF: Brain-derived neurotrophic factor; FGF-2: Fibroblast growth factor 2; GDNF: Glial cell line derived neurotrophic factor; IGF: Insulin-link growth factor; IL-1ß: Interleukin-1ß; NGF: Neural growth factor; PBS: Phosphate-buffered saline; PNL: Partial sciatic nerve ligation.


Assuntos
Terapia por Exercício , Regeneração Nervosa , Neuropatia Ciática/patologia , Neuropatia Ciática/terapia , Natação , Animais , Modelos Animais de Doenças , Masculino , Camundongos Endogâmicos BALB C , Síndromes de Compressão Nervosa/patologia , Síndromes de Compressão Nervosa/terapia , Degeneração Neural/patologia , Degeneração Neural/terapia , Neuralgia/patologia , Neuralgia/terapia , Distribuição Aleatória , Nervo Isquiático/patologia
20.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 40(3): 344-348, 2018 Jun 28.
Artigo em Chinês | MEDLINE | ID: mdl-29978790

RESUMO

Objective To evaluate the effectiveness of radial extracorporeal shockwave therapy(rESWT) for the treatment of superior lateral brachial cutaneous nerve(SLBCN) compression syndrome.Methods A total of 40 patients with SLBCN compression syndrome who were treated in our department from March 2013 to October 2015 were equally randomized into two groups according to random number table:rESWT group(treated with rESWT for 1 cycle) and control group(treated with local hormone injection for 1 cycle). Visual analogue scale(VAS) and Constant-Murley scale(CMS) were applied to evaluate the shoulder joint function before treatment and 1 month and 1 year after treatment. Results The average CMS scores were(66.7±0.9) and(65.7±1.1)scores in rESWT group and control group,respectively,before treatment(t=0.67,P=0.510) and were(86.9±1.0) and(86.4±1.1)scores one month after treatment(t=0.35,P=0.730);it increased to(89.7±0.7) scores in rESWT group one year later,which was significantly higher than that in control group[(85.3±0.8)scores](t=3.56,P=0.002). The improvement rate was 95% in rESWT group and only 75% in control group. Before treatment,the median VAS score in rESWT group and control group were 5.00(5.00,6.00) and 5.00(4.00,5.75)scores(u=1.13,P=0.29);one month after treatment,the median VAS score in these two groups were 2(1.00,2.75) and 2.00(1.00,2.00)scores(u=0.04,P=0.85);one year later,it was 1.00(0.00,1.00) scores in rESWT group,significantly lower than that in [2.00(1.00,2.00)scores] control group(u=5.09,P=0.02). Conclusion Compared with local hormone injection,rESWT can remarkably alleviate pain and restore shoulder joint function in patients with SLBCN compression syndrome after one year of treatment.


Assuntos
Tratamento por Ondas de Choque Extracorpóreas , Síndromes de Compressão Nervosa/terapia , Humanos , Dor , Resultado do Tratamento
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