Home About us Contact
|
Home About us Contact | ||
|
|
||
Common Peroneal Nerve (common + peroneal_nerve)
Selected AbstractsA composite poly-hydroxybutyrate,glial growth factor conduit for long nerve gap repairsJOURNAL OF ANATOMY, Issue 6 2003P.-N. Mohanna Abstract There is considerable evidence that peripheral nerves have the potential to regenerate in an appropriate microenvironment. We have developed a novel artificial nerve guide composed of poly 3-hydroxybutyrate (PHB) filled with glial growth factor (GGF) suspended in alginate hydrogel. Gaps of 2,4 cm in rabbit common peroneal nerve were bridged using a PHB conduit containing either GGF in alginate hydrogel (GGF) or alginate alone (Alginate), or with an empty PHB conduit (Empty). Tissues were harvested 21, 42 and 63 days post-operatively. Schwann cell and axonal regeneration were assessed using quantitative immunohistochemistry. At 21 days, addition of GGF increased significantly the distance of axonal and Schwann cells regeneration in comparison with that observed in Alginate and Empty conduits for both gap lengths. The axons bridged the 2-cm GGF conduits gap by 63 days, with a comparable rate of regeneration seen in 4-cm conduits. Schwann cells and axonal regeneration quantity was similar for both gap lengths in each group. However, at all time points the quantity of axonal and Schwann cells regeneration in GGF grafts was significantly greater than in both Alginate and Empty conduits, the latter showing better regeneration than Alginate conduits. The results indicate an inhibitory effect of alginate on regeneration, which is partially reversed by the addition of GGF to the conduits. In conclusion, GGF stimulates a progressive and sustainable regeneration increase in long nerve gap conduits. [source] Combined peroneal and proximal tibial nerve palsies,MICROSURGERY, Issue 4 2009Eric H. Williams M.D. Combined compression of both the common peroneal nerve and the proximal tibial nerve at the level of the popliteal fossa is rare. Recently, an anatomic site of compression of the proximal tibial nerve at the soleal sling (originating arch for the soleus muscle) has been described in cadavers. The present report includes three patients who had a combined compression of the common peroneal nerve at the fibular neck (fibular tunnel syndrome) and compression of the proximal tibial nerve at the soleal sling (soleal sling syndrome). In each case, blunt trauma was the precipitating event. Neurolysis of both nerves resulted in restoration of motor and sensory function in each ofthese three patients. This is the first clinical report illustrating combined neurolysis of the common peroneal at the knee and the proximal tibial nerve in the soleal sling. © 2009 Wiley-Liss, Inc. Microsurgery, 2009. [source] Functional Electrical Stimulation-Supported Interval Training Following Sensorimotor-Complete Spinal Cord Injury: A Case SeriesNEUROMODULATION, Issue 3 2009Jack Crosbie PhD ABSTRACT Objective.,To investigate the effect of interval training supported by Functional Electrical Stimulation (FES) on ambulation ability in complete spinal cord injury (SCI). Methods.,We trained four men with sensorimotor-complete (ASIA A) SCI, who achieved gait through FES of the quadriceps femoris, gluteus maximus, and common peroneal nerve on each side on a motorized treadmill. Training involved progressive interval walking exercise, consisting of periods of activity followed by equal periods of rest, repeated until muscle fatigue. We used time to muscle fatigue during continuous treadmill ambulation as the primary outcome measure. We also recorded the patterns of incremental stimulation for all training and testing sessions. Results.,All subjects increased their ambulation capacity; however, the responses varied from subject to subject. Some subjects increased the total distance walked by as much as 300% with progressive improvement over the entire training period; however, others made more modest gains and appeared to reach a performance plateau within a few training sessions. Conclusions.,FES-supported interval training offers a useful and effective strategy for strength-endurance improvement in the large muscle groups of the lower limb in motor-complete SCI. We believe that this training protocol offers a viable alternative to that of continuous walking training in people with SCI using FES to aid ambulation. [source] Clinical Application of Peroneal Nerve Stimulator System Using Percutaneous Intramuscular Electrodes for Correction of Foot Drop in Hemiplegic PatientsNEUROMODULATION, Issue 4 2006Yoichi Shimada MD Abstract Objective., To assess the orthotic effect of a functional electrical stimulation device (Akita Heel Sensor System; AHSS) in the treatment of hemiplegic gait with foot drop. Materials and Methods., In the AHSS, a heel sensor is attached to a small plastic heel brace, and the peroneal nerve is stimulated via percutaneous intramuscular electrodes. During the swing phase of the hemiplegic gait, the common peroneal nerve is stimulated by the AHSS. Eight patients in chronic stages of hemiplegia participated in this study. Walking speeds and step cadences on a 10-m course were compared between walking with stimulation and walking without stimulation. Results., Mean walking speed (± SD) was 0.50 ± 0.26 m/sec without stimulation and 0.64 ± 0.31 m/sec with stimulation. The mean percentage increase in walking speed with stimulation was 30.1%. Mean step cadence was 31 ± 7 steps/10 m without stimulation and 27 ± 7 steps/10 m with stimulation. By correcting foot drop, the AHSS significantly increased walking speed and decreased cadence (p < 0.05). Conclusion., The AHSS can significantly improve walking in hemiplegic patients with foot drop. [source] Effects of deep and superficial experimentally induced acute pain on muscle sympathetic nerve activity in human subjectsTHE JOURNAL OF PHYSIOLOGY, Issue 1 2009A. R. Burton Human studies conducted more than half a century ago have suggested that superficial pain induces excitatory effects on the sympathetic nervous system, resulting in increases in blood pressure (BP) and heart rate (HR), whereas deep pain is believed to cause vasodepression. To date, no studies have addressed whether deep or superficial pain produces such differential effects on muscle sympathetic nerve activity (MSNA). Using microneurography we recorded spontaneous MSNA from the common peroneal nerve in 13 awake subjects. Continuous blood pressure was recorded by radial arterial tonometry. Deep pain was induced by intramuscular injection of 0.5 ml hypertonic saline (5%) into the tibialis anterior muscle, superficial pain by subcutaneous injection of 0.2 ml hypertonic saline into the overlying skin. Muscle pain, with a mean rating of 4.9 ± 0.8 (s.e.m.) on a 0,10 visual analog scale (VAS) and lasting on average 358 ± 32 s, caused significant increases in MSNA (43.9 ± 10.0%), BP (5.4 ± 1.1%) and HR (7.0 ± 2.0%) , not the expected decreases. Skin pain, rated at 4.9 ± 0.6 and lasting 464 ± 54 s, also caused significant increases in MSNA (38.2 ± 12.8%), BP (5.1 ± 2.1%) and HR (5.6 ± 2.0%). The high-frequency (HF) to low-frequency (LF) ratio of heart rate variability (HRV) increased from 1.54 ± 0.25 to 2.90 ± 0.45 for muscle pain and 2.80 ± 0.52 for skin pain. Despite the different qualities of deep (dull and diffuse) and superficial (burning and well-localized) pain, we conclude that pain originating in muscle and skin does not exert a differential effect on muscle sympathetic nerve activity, both causing an increase in MSNA and an increase in the LF : HF ratio of HRV. Whether this holds true for longer lasting experimental pain remains to be seen. [source] Evolution of histoid leprosy (de novo) in lepromatous (multibacillary) leprosyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2005Virendra N. Sehgal MD A 26-year-old man presented with persistent redness of the face over the past 2 years and thickening of the ears for a year. The current state was preceded by three to four episodes of epistaxis, 2,3 months previously. The patient had not received any treatment. Cutaneous examination revealed indurated (infiltrated) plaques on the face and ears over an apparently normal-looking skin, and numerous, small, ill-defined, slightly hypopigmented, shiny macules all over the body. They were bilateral and symmetric (Fig. 1a,b). There was no variation in the cutaneous sensations of temperature, touch, and pain. The patient showed loss of the lateral eyebrows and conjunctival congestion. Examination of the nerves revealed enlargement of the ulnar, radial, posterior tibial, and right common peroneal nerves; however, there was no tenderness of the nerves. Systemic examination was within normal limits. Examination of a slit-skin smear (under oil immersion), prepared from a representative lesion (plaque), demonstrated an abundance of solid and uniform-staining acid-fast bacilli, occurring either singly or in parallel clumps/globii, in an average field (6+). Furthermore, a scraping mount (10% KOH) prepared from the lesion on the back was negative. Figure 1. (a, b) Histoid leprosy Hematoxylin and eosin-stained sections prepared from a biopsy taken from a plaque revealed a conspicuous granuloma composed of peculiar spindle-shaped histiocytes. Several of the granulomas were present in the mid and lower dermis. They were characterized by whorled, criss-cross, or parallel patterns. Solid and uniform-staining, slender, rod-like (length three times that of the breadth) acid-fast bacilli were found scattered throughout the section. A few histiocytes closely packed with acid-fast bacilli, together with lymphocytic infiltrates, were also seen. There was a prominent eosinophilic stained clear zone just below the epidermis. It was free from acid-fast bacilli as well as the inflammatory infiltrate (Fig. 2a,b). A definitive diagnosis of untreated lepromatous leprosy (LL) changing to histoid leprosy (de novo) was made. Figure 2. (a, b) Histoid leprosy depicting granuloma formed by histiocytes displaying whorl-wind, criss-cross or interlacing pattern, and a clear zone beneath the epidermis (H&E ×40) Solid and uniform staining acid fast bacilli, , slender, rod-like, length 3 times that of breadth found scattered throughout the granuloma (H&E ×100) [source] Ultrasound guidance for a lateral approach to the sciatic nerve in the popliteal fossaANAESTHESIA, Issue 10 2004C. J. L. McCartney Summary Descriptions of the use of ultrasound for nerve location have focused on upper limb blocks. We present a case in which ultrasound imaging was used for a lateral approach to the sciatic nerve in the popliteal fossa. Ultrasound images taken proximal to the popliteal crease showed tibial and common peroneal nerves as round hyperechoic structures superficial and lateral to the tibial artery. Under direct ultrasound guidance, we placed a block needle close to the tibial nerve and confirmed its position with nerve stimulation. Injected local anaesthetic was seen on ultrasound as it spread around both tibial and common peroneal nerves. [source] | |||||||||||||