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Nerve Entrapment at Shoulder and Arm

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Focal Peripheral Neuropathies

Abstract

The entire shoulder and arm nerves are detailed as far as they can be involved by focal lesion entrapment. Anatomy, variants, damaging factors, patient’s presentation of clinical symptoms, value of special electrodiagnostic tests and of supplementary modern imaging techniques, and finally, the surgical approach in case of a diagnosed entrapment of these nerves are described. Each one needs knowledge about which differential-diagnostic aspect has to be taken into account, and which diagnostic tool – electrodiagnosis and/or imaging – has to be used, particularly if there are doubts about whether there could be etiology other than by a simple entrapment. The astonishing value of high resolution ultrasound and several MRI techniques is outlined in these cases. Their value is demonstrated in many figures. Particular attention is repeatedly focussed on the Parsonage-Turner syndrome which may involve special nerve fibers within the brachial plexus and long segments of peripheral nerve trunks. Not only the muscles of the shoulder girdle such as the serratus anterior or deltoid muscles are affected by this inflammatory disease but also e.g. muscles supplied by the interosseus anterior or interosseus posterior nerves. It is argued that diagnosis has to be assessed before worthwhile surgery is started.

Finally, however, surgical instructions are added as figures in order to give an optimal idea of nerve release procedures in uncommon compression cases.

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  1. Neurological Department, Freiberg Hospital, Freiberg, Germany

    Josef Böhm

  2. Neurosurgical Department, Friederiken-Hospital, Hannover, Germany

    Götz Penkert

  3. Neurological Department, Municipal Hospital Dessau, Dessau-Rosslau, Germany

    Thomas Schelle

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Böhm, J., Penkert, G., Schelle, T. (2015). Nerve Entrapment at Shoulder and Arm. In: Focal Peripheral Neuropathies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54780-5_8

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