Abstract:
Entrapment neuropathies of the lower limb are a misunderstood and underdiagnosed group of disorders, characterized by pain and dysesthesia, muscular weakness, and specific provoking movements on physical examination. The most frequent of these syndromes encountered in clinical practice are fibular nerve entrapment, proximal tibial neuropathy, sural nerve neuropathy, deep gluteal syndrome or sciatic nerve entrapment, and lateral femoral cutaneous nerve entrapment, also known as meralgia paresthetica. These are commonly mistaken for lumbar plexopathies, radiculopathies, and musculotendinous diseases, which appear even more frequently and have overlapping clinical presentations. A comprehensive anamnesis, physical examination, and electrodiagnostic studies should help clarify the diagnosis. If the diagnosis is still unclear or a secondary cause of entrapment is suspected, magnetic resonance neurography, MRI, or ultrasonography should be conducted to clarify the etiology, rule out other diseases, and confirm the diagnosis. The aim of this narrative review was to help clinicians gain familiarity with this disease, with an increase in diagnostic confidence, leading to early diagnosis of nerve damage and prevention of muscle atrophy. We reviewed the epidemiology, anatomy, pathophysiology, etiology, clinical presentation, and EDX technique and interpretation of the entrapment neuropathies of the lower limb, using articles published from 1970 to 2022 included in the Pubmed, MEDLINE, Cochrane Library, Google Scholar, EMBASE, Web of Science, and Scopus databases.
摘要:
下肢压迫性神经病是一种被误解和未被诊断的疾病,以疼痛和感觉障碍为特征,肌肉无力,以及体检中特定的挑衅性动作。在临床实践中最常见的这些综合征是腓骨神经卡压,胫骨近端神经病,腓肠神经神经病,臀深综合征或坐骨神经卡压,股外侧皮神经卡压,也被称为meralgia异常。这些通常被误认为是腰丛疾病,神经根病,和肌肉肌腱疾病,出现频率更高,临床表现重叠。一个全面的回忆,体检,和电诊断研究应该有助于澄清诊断。如果诊断仍不清楚或怀疑是导致截留的次要原因,磁共振神经成像,MRI,或超声检查应明确病因,排除其他疾病,并确认诊断。这篇叙述性综述的目的是帮助临床医生熟悉这种疾病,随着诊断信心的增加,导致神经损伤的早期诊断和肌肉萎缩的预防。我们回顾了流行病学,解剖学,病理生理学,病因学,临床表现,和EDX技术和下肢压迫性神经病的解释,使用1970年至2022年出版的文章,MEDLINE,科克伦图书馆,谷歌学者,EMBASE,WebofScience,和Scopus数据库。