Entrapment Syndromes

The phantom limb pain the woman is experiencing is described as a painful condition of the amputated limb after the stump has completely healed. It is a chronic pain that occurs in more than 80% of amputees especially those who suffered pain in the limb before the amputation. Theories suggest that phantom limb pain results from redevelopment or hyperactivity of cut peripheral nerves, scar tissue or neuroma formation in the cut peripheral nerves, spinal cord deafferentation, and alterations in the thalamus and cortex. More so, the CNS integration, which involves reorganization and plastic modifications of the somatosensory cortex, effects the receptors in perceiving the pain of the amputated limb despite of the limb itself being absent. In addition,

Mononeuritis multiplex is asymmetric, sensory and motor peripheral neuropathy. Mononeuritis multiplex is not as frequent as in adults (3); cutaneous and neurological involvements of the extremities were present in our patient as previously described by Kawakami and friends (18). Albahri et al. reported 17 year old Czech girl who had hypoesthesia and paresthesia with a progressive right tibioperoneal nerve paresis, after the two years of disease could successfully conduct her activities of daily life but she had minor paresis (19). Our patient had severe pain and sensorimotor neuropathy in all extremities at admission, after pulse methylprednisolone complaint of pain reduced but slightly improvement in glove socks type sensory loss was seen.

b. Local Redness/Heat: The pains were more than just muscle spasms. It burned, felt hot where the surgery had been, & when she took off her cast, the skin around her lower spine was swollen and bright red.

Some individuals would only experience “mild” symptoms such as skin lesions, swelling, or nerve damage and this was known

The clinical presentation of DPN vary markedly from one patient to another depending on the type of sensory fibers involved. About 50% of patients is symptomatic, commonly present with a burning

Nerve injury is not fatal but can severely impact quality of life. Peripheral nerve injuries occur in an estimated 2-3% of all patients admitted to a Level 1 trauma center (1) and are commonly caused by trauma to the upper limbs. The economic impact of nerve injuries can be large with operative costs, hospital charges, rehabilitation visits, and lost time at work. Only subtle improvements to peripheral nerve repair have been made recently, and our current knowledge of nerve physiology and regeneration vastly exceeds our current repair capabilities.

This loss of water affects homeostasis and until skin is repaired and the patient is on their way to recovery they may not have the ability to properly maintain their water levels to remain in a homeostatic state. This results in the need for fluids to be given to the patient through an IV at the same rate the patient is losing fluid to avoid both death and shock. The amount of fluid being lost can be calculated using the Rule of Nines and the patients body weight. While burns may not spread to others it may spread to affect more than just the integumentary system; severe burns may reach bone infecting the skeletal system, severe burns damage or destroy nerve endings causing an effect on the nervous system, the inability to retain fluids in severe burn patients causes dehydration affecting the urinary system.

When burn wounds present to a health care setting, they should be assessed and the provider should decide if it is treatable for their setting, or if a higher level of care is in order. For patients who present with deep partial thickness burns to a localized area such as the arm and hand, an initial cleaning of the wound should be performed. All blisters should be deroofed, and once the wound is cleansed, it should be placed in a hydrocolloid dressing (Zacharevskij et al., 2017). SSD cream should not be placed on these wounds.

Due to the anterolateral tract in the spinal cord, which controls the processes of pain and touch, there would be absence of light touch, vibration, and position of sense ipsilateral, below the area of trauma. Loss of bladder and bowel control may be a symptom. Damage to the lateral corticospinal tract causes paralysis on the same side of the injury (Monoplegia), and damage to the lateral spinothalamic tract causes absence of pain and temperature sensation on the contralateral side of the body to which the trauma occurred.

The study into the mechanics behind abnormal thermoregulation has been investigated in different ways, however these two studies (as well as numerous others) agree that prolonged vasoconstriction of cutaneous blood vessels (post-denervation hypersensitivity) is a primary cause of the peripheral coldness experienced by many sufferers of PD. Different methods were used to observe this phenomenon, both of which are valid however they also deal with other variables. **Shindo et. al** chose to focus on electric stimulation producing a response, of which they measured skin sympathetic nerve activity, reflex burst amplitude, decrease of blood flow and recovery time. Ultimately the only variables which were relevant to the understanding of thermoregulation

The authors states that Lower Extremity Nerve Entrapment Syndromes can include the following nerves and branches: Saphenous nerve, Obturator nerve, Superficial peroneal nerve, Common peroneal nerve, Lateral, Iliohypogastric nerve, femoral cutaneous nerve, Ilioinguinal nerve, Genitofemoral nerve, Deep peroneal nerve, Plantar nerves, Digital nerves, and Femoral nerve.

• Tingling, numbness, or a burning feeling in the hand or fingers. This may be worse in the two fingers farthest from the thumb.

Clinical manifestations are a direct result of trauma that causes cord compression, ischemia, edema, and possible cord transection (L. Dambaugh, personal communication, November 3, 2015). The individual’s signs and symptoms depend on the level and degree of injury. The higher the injury is on the spine, the more serious the clinical manifestations are because everything below the injury site is affected. Respiratory issues occur with cervical spine involvement. If the injury is above C4, there is a total loss of respiratory function because the communication between the respiratory control center and the body is disconnected. If the injury is below C4 and the phrenic nerve is involved the patient will experience diaphragmatic breathing and likely hypoventilation. When the injury is thoracic, abdominal and intercostal muscles are affected and patients are at risk for

A peripheral neuropathy is an injury to the peripheral nerves which can result in pains and weakness of the hands and feet. A peripheral neuropathy can be caused by a traumatic injury or an infection. Symptoms and sings for a peripheral neuropathy depend on the types of nerves that are affected including: sensory, motor and autonomic nerves. The signs and symptoms of these three types of nerves are: pains as burning in the hands, arms, feet or legs, weak muscles, falling down, dizziness and digestion problems etc… There are a lot of reasons why a person will have a peripheral neuropathy including alcohol, infection, diabetes, medications, inherited and taking poisons. Moreover, it’s safer to see a specialist in

Burning in the elbow area is the number one symptoms of this injury which can result in weakness of the hand and forearm