Entrapment and Compressive Neuropathies

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Entrapment and compressive neuropathies of the upper and lower extremities are frequently encountered disorders in the office. Certain clinical clues in the history and examination, along with electrodiagnostic testing and imaging studies, often suggest the correct diagnosis. Some of the more common neuropathies are discussed, along with suggestions regarding testing and treatment.

Section snippets

Case vignette

A 34-year-old right-handed woman described intermittent pain of the right hand and wrist with tingling of the index and middle fingers. Symptoms had been present for 6 months, often awakening her from sleep at night. She also noted aching in her arm extending into the shoulder. Symptoms worsened while holding a telephone or book, or driving. Shaking out her hand or placing it under warm running water offered minimal relief of symptoms. She had difficulty buttoning her shirt and opening jars,

Case vignette

A 20-year-old man developed a right foot drop after leaving a movie theater. He was unable to dorsiflex the right foot and toes, and described tingling over the top of the foot. He tended to slap the right foot when walking. Examination showed a thin young man who had severe weakness of the right ankle and toe dorsiflexors and ankle evertors. Ankle inversion appeared slightly weak. The remainder of his strength was normal, including ankle and toe plantar flexors, knee flexors and extensors, and

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