Pronator teres syndrome is characterized by compression of the median nerve, leading to dysfunction of the affected limb. Median nerve entrapment causes paresthesia, changes in sensitivity, and loss of strength in the fingers, in addition to causing loss of hand dexterity. The diagnosis of pronator teres syndrome is complicated, due to its similarity with other neuropathies of the median nerve. So, it is important to emphasize the need for a physical examination together with imaging tests, especially ultrasound, for its correct diagnosis. We report the case of a 28-year-old woman who complained of tingling for ten years in the proximal third of the left forearm at rest that worsens on exertion and weakness if not moving. On physical examination, she has no limitation of movement but refers to a feeling of weakness and numbness in his forearm. Ultrasonography demonstrates compression of the median nerve between the ulnar and humeral heads of the pronator teres muscle, a finding confirmed by magnetic resonance imaging and electroneuromyography. The patient was treated with physiotherapy presenting improvement of symptoms after 45 days.

• MeSH
• Arthrogryposis MeSH
• Adult MeSH
• Electromyography methods   MeSH
• Hereditary Sensory and Motor Neuropathy MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Median Neuropathy diagnosis   MeSH
• Forearm MeSH
• Ultrasonography methods   MeSH
• Nerve Compression Syndromes diagnosis   physiopathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

Na podkladě fyzikálních příčin vznikají v pracovní zátěži mononeuropatie (úžinové syndromy i komprese periferních nervů) i polyneuropatie. Nejčastějším fyzikální vlivem je přetížení, dále následuje expozice vibracím přenášeným na horní končetiny, ale také chlad, vlhko, nepříznivá pracovní poloha, tlak na nerv proti tvrdé podložce. Úžinové syndromy i zevní komprese periferního nervu vedou k ischemii fasciklů i jednotlivých axonů, k rozvoji edému, k poruše venózního odtoku, k vzestupu tlaku v úžině a nakonec i k fokální demyelinizaci či axonální lézi. Nadlimitní vibrace přenášené na horní končetinu vedou ke spazmům arteriol, k ischemii tkáně na akru HK, k poškození senzitivních a pak i motorických vláken a k rozvoji vibrační neuropatie. Důležité je klinické a elektrofyziologické zhodnocení. Následuje léčba a komplexní preventivní opatření.

Mononeuropathies (entrapment syndromes and compressions of peripheral nerves) and polyneuropathies develop during occupational exposition on the ground of physical reasons. The most common physical impact is overload, followed by exposition to vibrations transmitted to upper extremities, then cold, humidity, unfavorable position in work, and pressure on the nerve against a hard structure. Entrapment syndromes and outer compressions of peripheral nerves lead to the ischemic changes of fascicles and single axons, to development of oedema, to failure of the venous outflow, to the increase of pressure in entrapment and lastly to the focal demyelinization or axonal lesion. Over-limit vibration transferred via the upper extremity cause spasms of arteriols, leading to the tissue ischemia at the terminal structures of hand and fingers, to lesion of sensitive and later of motor nerve fibres and to the development of vibration neuropathy. Clinical and electrophysiological evaluation of these disorders is important. Treatment and the complex prophylactic measures follow.

• MeSH
• Electrodiagnosis methods   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Occupational Diseases diagnosis   prevention & control   MeSH
• Polyneuropathies MeSH
• Carpal Tunnel Syndrome diagnosis   etiology   therapy   MeSH
• Nerve Compression Syndromes * diagnosis   etiology   therapy   MeSH
• Tendon Entrapment MeSH
• Check Tag
• Humans MeSH

• MeSH
• Conservative Treatment MeSH
• Humans MeSH
• Cerebral Palsy diagnosis   etiology   rehabilitation   therapy   MeSH
• Neuromuscular Diseases * diagnosis   etiology   complications   therapy   MeSH
• Orthopedic Procedures methods   MeSH
• Poliomyelitis diagnosis   complications   prevention & control   therapy   MeSH
• Neonatal Brachial Plexus Palsy diagnosis   etiology   therapy   MeSH
• Nerve Compression Syndromes diagnosis   etiology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Práce se zabývá profesionálními periferními neuropatiemi typu úžinových syndromů na horních končetinách a posuzováním invalidity. Popisuje dosavadní poznatky o syndromu karpálního a kubitálního tunelu, jejich etiologii, klinický obraz, vyšetřovací metody a léčbu. Jsou též uvedena statistická data o počtu uznaných nemocí z povolání, o invaliditách a kazuistiky.

The work deals with professional peripheral neuropathies such as strait syndromes in the upper limbs and disability assessment. It describes the current knowledge about the carpal and cubital tunnel syndrome, their etiology, clinical picture, examination methods and treatment. Statistical data on the number of recognized occupational diseases, disabilities and case reports are also provided.

• MeSH
• Adult MeSH
• Electromyography MeSH
• Middle Aged MeSH
• Humans MeSH
• Occupational Diseases * diagnosis   epidemiology   etiology   MeSH
• Disability Evaluation MeSH
• Carpal Tunnel Syndrome diagnosis   etiology   therapy   MeSH
• Cubital Tunnel Syndrome diagnosis   etiology   therapy   MeSH
• Nerve Compression Syndromes * diagnosis   etiology   therapy   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Case Reports MeSH
• Review MeSH

Autoři prezentují kazuistiku vzácného syndromu útlaku nervus interosseus antebrachii anterior ("Kiloh-Nevinův syndrom"). Pacientku nejprve vyšetřili ve spádové neurologické ambulanci. Na základě minimální neuropatie nervus medianus v karpálním tunelu, verifikované na EMG a na základě klinického nálezu byla stanovena diagnóza syndromu karpálního tunelu. Konzilium na Neurochirurgické ambulanci autorského pracoviště konstatovalo nepřítomnost klinických symptomů korespondujících s uvedenou diagnózou, a to vč. EMG nálezu. Doporučené EMG došetření odhalilo neuropatii nervus interosseus antebrachii anterior (Kiloh-Nevinovův syndrom). Pacientka podstoupila, po pokusu o konzervativní terapii, operační výkon s příznivým efektem.

Authors would like to present a case of an uncommon entrapment syndrome of the anterior antebrachial interosseal nerve ("The Kiloh-Nevin syndrome). Patient was first examined by an ambulatory neurologist. EMG verified minimal neuropathic finding of the median nerve and clinical presentation first lead to the diagnosis of carpal tunnel syndrome. After a neurosurgical consult on the authors departement we found the corresponding clinical presentation misleading including the EMG presentation. Newly recommended EMG uncovered anterior antebrachial interosseal nerve neuropathy (Kiloh-Nevin syndrome). After a failed conservative therapy, patient underwent a surgical intervention with a good outcome.

• MeSH
• Electromyography methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Mononeuropathies surgery   diagnosis   MeSH
• Median Nerve surgery   pathology   MeSH
• Nerve Compression Syndromes * surgery   diagnosis   pathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Některé případy poškození periferních nervů z přetěžování či vibrací mohou být za určitých okolností uznány jako nemoc z povolání (NZP). Rozhodnutí o uznání či neuznání NZP je v kompetenci věcně i místně příslušného "Střediska nemocí z povolán"“. V procesu uznání NZP připadá významné místo neurologickému konziliáři. V průběhu minulých 20 let tvořila onemocnění neurologického charakteru 29,6 % všech NZP. Přitom profesionální poškození z přetěžování či vibrací představovala 98,5 %. V prvé řadě se jedná o syndrom karpálního tunelu, méně často o lézi n. ulnaris (NU) v lokti a výjimečně o lézi NU v oblasti ruky – Guyonova kanálu. Na vzniku profesionálních poškození periferních nervů z fyzikálních příčin se podílí mechanický tlak, přetížení ruky, přenos vibrací na horní končetinu, chlad, nevýhodná poloha při práci a další faktory. Pro uznání profesionálního původu je nezbytné zjistit přítomnost odpovídajících klinických příznaků a nález na EMG vyšetření odpovídající nejméně středně těžké poruše. V práci jsou uvedeny anamnestické, klinické i EMG charakteristiky, včetně definice elektrofyziologických parametrů středního stupně postižení pro n. medianus i NU.

Some lesions of the peripheral nerves caused by physical factors can, under certain conditions, be acknowledged as an occupational disease. The decision whether it is an occupational disease or not is authorized by the "Centre of occupational diseases". Neurological consultants have a very important role in the process of acknowledgement of an occupational disease. During the last 20 years, disorders of neurological character represented 29.6% of all occupational diseases. At the same time, the lesions of the peripheral nerves due to overload or vibration constituted 98.5%. Carpal tunnel syndrome is most frequent, followed less often by an ulnar nerve lesion in the elbow, and rarely by an ulnar nerve lesion in the wrist and hand - the Guyon‘s channel. In the development of occupational compressive neuropathies, various mechanisms take place: mechanical pressure, hand overload, transmission of vibration on the upper extremity, cold, inappropriate position during work, and other factors. For acknowledgement of occupational origin of such a lesion, it is essential to determine clinical signs and symptoms, and EMG examination corresponding to at least the moderately severe lesion. Anamnestic, clinical, and EMG characteristics including electrophysiological parameters of a moderately severe lesion for the median and ulnar nerves were defined.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Occupational Diseases * diagnosis   etiology   pathology   MeSH
• Median Nerve pathology   MeSH
• Ulnar Nerve pathology   MeSH
• Carpal Tunnel Syndrome * diagnosis   epidemiology   etiology   therapy   MeSH
• Ulnar Nerve Compression Syndromes * diagnosis   epidemiology   etiology   therapy   MeSH
• Nerve Compression Syndromes diagnosis   etiology   therapy   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH
• Review MeSH

• MeSH
• Decompression, Surgical methods   trends   MeSH
• Computed Tomography Angiography methods   trends   MeSH
• Endovascular Procedures * methods   trends   MeSH
• Humans MeSH
• Magnetic Resonance Angiography methods   MeSH
• Interdisciplinary Communication MeSH
• Rehabilitation methods   trends   MeSH
• Thoracic Outlet Syndrome * diagnosis   etiology   therapy   MeSH
• Cervical Rib Syndrome diagnosis   etiology   therapy   MeSH
• Thrombolytic Therapy methods   MeSH
• Nerve Compression Syndromes diagnosis   etiology   therapy   MeSH
• Vascular Surgical Procedures * methods   trends   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Surgical Procedures, Operative methods   MeSH
• Diagnostic Techniques and Procedures MeSH
• Endoscopy methods   MeSH
• Conservative Treatment MeSH
• Humans MeSH
• Peroneal Neuropathies surgery   diagnosis   etiology   MeSH
• Carpal Tunnel Syndrome * surgery   diagnosis   etiology   therapy   MeSH
• Cubital Tunnel Syndrome surgery   diagnosis   therapy   MeSH
• Ulnar Nerve Compression Syndromes surgery   diagnosis   etiology   MeSH
• Nerve Compression Syndromes * surgery   diagnosis   etiology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Pain * etiology   classification   MeSH
• Diagnosis, Differential MeSH
• Lower Extremity pathology   MeSH
• Fibromyalgia diagnosis   drug therapy   physiopathology   therapy   MeSH
• Glucocorticoids administration & dosage   MeSH
• Injections adverse effects   MeSH
• Knee pathology   MeSH
• Complex Regional Pain Syndromes diagnosis   classification   therapy   MeSH
• Hip pathology   MeSH
• Humans MeSH
• Elbow pathology   MeSH
• Pain Management classification   MeSH
• Pain Measurement MeSH
• Musculoskeletal Diseases * etiology   classification   therapy   MeSH
• Joint Instability diagnosis   etiology   therapy   MeSH
• Prognosis MeSH
• Risk Factors MeSH
• Hand pathology   MeSH
• Tendons pathology   MeSH
• Practice Guidelines as Topic MeSH
• Fatigue Syndrome, Chronic diagnosis   therapy   MeSH
• Carpal Tunnel Syndrome diagnosis   etiology   therapy   MeSH
• Cubital Tunnel Syndrome diagnosis   therapy   MeSH
• Shoulder Impingement Syndrome diagnosis   classification   pathology   therapy   MeSH
• Tennis Elbow diagnosis   etiology   therapy   MeSH
• Nerve Compression Syndromes diagnosis   classification   physiopathology   therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Medical History Taking MeSH
• Audiometry, Pure-Tone methods   utilization   MeSH
• Audiometry, Speech methods   utilization   MeSH
• Diagnostic Techniques, Otological MeSH
• Diagnostic Imaging methods   utilization   MeSH
• Diagnosis, Differential MeSH
• Electronystagmography methods   utilization   MeSH
• Drug Therapy methods   utilization   MeSH
• Carbamazepine MeSH
• Disease Attributes MeSH
• Middle Aged MeSH
• Humans MeSH
• Microvascular Decompression Surgery MeSH
• Vestibulocochlear Nerve * physiopathology   MeSH
• Evoked Potentials, Auditory, Brain Stem physiology   MeSH
• Statistics as Topic MeSH
• Nerve Compression Syndromes * diagnosis   etiology   therapy   MeSH
• Vertigo * MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH