関: entrapment neuropathy、nerve entrapment

WordNet

applying pressure (同)compressing
encoding information while reducing the bandwidth or bits required
the process or result of becoming smaller or pressed together; "the contraction of a gas on cooling" (同)condensation, contraction
any bundle of nerve fibers running to various organs and tissues of the body (同)nervus
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"
control of your emotions; "this kind of tension is not good for my nerves"

PrepTutorEJDIC

圧搾,圧傷;要約
〈C〉『神経』 / 〈C〉《複数形で》『神経過敏』,いらだち / 〈U〉『勇気』,度胸(courage) / 〈U〉《時にa ~》厚かましさ,ずぶとさ;無礼 / 〈C〉葉脈;(昆虫の)翅脈(しみゃく) / 〈人,特に自分〉‘に'力を与える,‘を'元気づける
(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/14 12:39:41」(JST)

wiki en

Nerve compression syndrome or compression neuropathy, also known as entrapment neuropathy, is a medical condition caused by direct pressure on a single nerve. It is known colloquially as a trapped nerve, though this may also refer to nerve root compression (by a herniated disc, for example).^[1] Its symptoms include pain, tingling, numbness, and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. Nerve conduction studies help to confirm the diagnosis. In some cases, surgery may help to relieve the pressure on the nerve, but this does not always relieve all the symptoms.

Nerve injury by a single episode of physical trauma is in one sense a compression neuropathy, but is not usually included under this heading.

Pathophysiology

External pressure reduces flow in the vessels supplying the nerve with blood (the vasa nervorum). This causes local ischaemia, which has an immediate effect on the ability of the nerve axons to transmit action potentials. As the compression becomes more severe over time, focal demyelination occurs, followed by axonal damage, and finally scarring.

Causes

A nerve may be compressed by prolonged or repeated external force, such as sitting with one's arm over the back of a chair (radial nerve), frequently resting one's elbows on a table (ulnar nerve), or an ill-fitting cast or brace on the leg (peroneal nerve).

Part of the patient's own body can cause the compression, and the term entrapment neuropathy is used particularly in this situation. The offending structure may be a well-defined lesion such as a tumour (for example a lipoma, neurofibroma or metastasis), a ganglion cyst or a haematoma. Alternatively, there may be expansion of the tissues around a nerve in a space where there is little room for this to occur, as is often the case in carpal tunnel syndrome. This may be due to weight gain or peripheral oedema (especially in pregnancy), or to a specific condition such as acromegaly, hypothyroidism or scleroderma and psoriasis.

Some conditions cause nerves to be particularly susceptible to compression. These include diabetes, in which the blood supply to the nerves is already compromised, rendering the nerve more sensitive to minor degrees of compression. The genetic condition HNPP is a much rarer cause.

Diagnosis

The symptoms and signs depend on which nerve is affected, where along its length the nerve is affected, and how severely the nerve is affected. Positive sensory symptoms are usually the earliest to occur, particularly tingling and neuropathic pain, followed or accompanied by reduced sensation or complete numbness. Muscle weakness is usually noticed later, and is often associated with muscle atrophy.

A compression neuropathy can usually be diagnosed confidently on the basis of the symptoms and signs alone. However, nerve conduction studies are helpful in confirming the diagnosis, quantifying the severity, and ruling out involvement of other nerves (suggesting a mononeuritis multiplex or polyneuropathy). A scan is not usually necessary, but may be helpful if a tumour or other local compressive lesion is suspected.

Nerve injury, as a mononeuropathy, may cause similar symptoms to compression neuropathy. This may occasionally cause diagnostic confusion, particularly if the patient does not remember the injury and there are no obvious physical signs to suggest it.

The symptoms and signs of each particular syndrome are discussed on the relevant pages, listed below.

Treatment

When an underlying medical condition is causing the neuropathy, treatment should first be directed at this condition. For example, if weight gain is the underlying cause, then a weight loss program is the most appropriate treatment. Compression neuropathy occurring in pregnancy often resolves after delivery, so no specific treatment is usually required.

Some compression neuropathies are amenable to surgery: carpal tunnel syndrome and cubital tunnel syndrome are two common examples. Whether or not it is appropriate to offer surgery in any particular case depends on the severity of the symptoms, the risks of the proposed operation, and the prognosis if untreated. After surgery, the symptoms may resolve completely, but if the compression was sufficiently severe or prolonged then the nerve may not recover fully and some symptoms may persist.

Drug treatment may be useful for an underlying condition (including peripheral oedema), or for ameliorating neuropathic pain.

List of syndromes

Upper limb

nerve	place	usually referred to as
median	carpal tunnel	carpal tunnel syndrome
median (anterior interosseous)	proximal forearm	anterior interosseous syndrome
median	pronator teres	pronator teres syndrome
median	ligament of Struthers	ligament of Struthers syndrome
ulnar	cubital tunnel	cubital tunnel syndrome
ulnar	Guyon's canal	Guyon's canal syndrome
radial	axilla	radial nerve compression
radial	spiral groove	radial nerve compression
radial (posterior interosseous)	proximal forearm	posterior interosseous nerve entrapment
radial (superficial radial)	distal forearm	Wartenberg's Syndrome
suprascapular	suprascapular notch	suprascapular nerve entrapment

Lower limb, abdomen and pelvis

nerve	place	usually referred to as
common peroneal	fibular neck	peroneal nerve compression
tibial	tarsal tunnel	tarsal tunnel syndrome
lateral cutaneous nerve of thigh	inguinal ligament	meralgia paraesthetica
sciatic	piriformis	piriformis syndrome [not always due to entrapment]
iliohypogastric	lower abdomen	iliohypogastric nerve entrapment
obturator	obturator canal	obturator nerve entrapment
pudendal	pelvis	pudendal nerve entrapment
abdominal cutaneous nerves	abdominal wall	abdominal cutaneous nerve entrapment syndrome

References

^ "COMPRESSIVE NEUROPATHY". Retrieved 2015-03-15.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 上肢末梢神経症候群の概要 overview of upper extremity peripheral nerve syndromes
2. 下肢末梢神経症候群の概要 overview of lower extremity peripheral nerve syndromes
3. 亜急性または慢性の手首の疼痛を有する成人の評価 evaluation of the adult with subacute or chronic wrist pain
4. 小児または思春期のアスリートにおける肘関節損傷 elbow injuries in the child or adolescent athlete
5. 小児または思春期のアスリートにおける頸髄および頸部末梢神経損傷の概要 overview of cervical spinal cord and cervical peripheral nerve injuries in the child or adolescent athlete

English Journal

Posterior interosseous nerve syndrome after pneumatic hammer use: An uncommon condition.

Nunes B1, Serdoura F1,2, Vital L1, Seara M1, Pinto R1.
American journal of industrial medicine.Am J Ind Med.2017 Jul;60(7):670-672. doi: 10.1002/ajim.22730. Epub 2017 May 9.
PMID 28485505

Extraforaminal compression of the L5 nerve: An anatomical study with application to failed posterior decompressive procedures.

Tubbs RS1, Iwanaga J2, Aly I3, Moisi MD4, Hanscom DR4, Chapman JR4, Loukas M3, Oskouian RJ5.
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia.J Clin Neurosci.2017 Jul;41:139-143. doi: 10.1016/j.jocn.2017.03.051. Epub 2017 Apr 10.
PMID 28408248

Peptide regulation of cofilin activity in the CNS: A novel therapeutic approach for treatment of multiple neurological disorders.

Shaw AE1, Bamburg JR2.
Pharmacology & therapeutics.Pharmacol Ther.2017 Jul;175:17-27. doi: 10.1016/j.pharmthera.2017.02.031. Epub 2017 Feb 20.
PMID 28232023

Japanese Journal

Far-out syndromeによりL5神経根症を呈した1例

宮本周一,大鳥精司,井上玄 [他]
千葉医学雑誌 87(1), 7-10, 2011-02
… His symptoms disappeared after injection of lidocaine onto the L5 spinal nerve. … The symptoms did not improve after conservative treatment, and surgery was performed under a diagnosis of neuropathy from far-out syndrome. … For release of L5 spinal nerve compression, decompression and instrumented fusion surgery were performed. … Far-out syndrome itself is rare; …
NAID 40018730698

Posterior Decompression of Far-Out Foraminal Stenosis Caused by a Lumbosacral Transitional Vertebra : —Case Report—

MIYOSHI Yasuyuki,YASUHARA Takao,DATE Isao
Neurologia medico-chirurgica 51(2), 153-156, 2011
… Diagnosis of unilateral far-out foraminal entrapment of the L5 spinal nerve below a transitional vertebra (TV) depended on selective radiculography and nerve root block. … Computed tomography after selective radiculography clearly demonstrated foraminal entrapment of the L5 nerve root via the osteophytes. …
NAID 130000442551

Related Pictures

★リンクテーブル★

リンク元	「神経圧迫症候群」「nerve entrapment」
拡張検索	「ulnar nerve compression syndrome」
関連記事	「compression」「nerve」「syndrome」