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Neurological Signs and Symptoms of True Neurogenic Thoracic Outlet Syndrome Mana Higashihara 1 , Fumie Konoeda 2 , Masahiro Sonoo 3 1Department of Neurology, Tokyo Metropolitan Geriatric Hospital 2Department of Neurology, Tokyo Saiseikai Central Hospital 3Department of Neurology, Teikyo University School of Medicine Keyword: 真の神経性胸郭出口症候群 , 非特異的胸郭出口症候群 , 腕神経叢 , 筋電図 , 内側前腕皮神経 , true neurogenic thoracic outlet syndrome , nonspecific thoracic outlet syndrome , brachial plexus , electromyography , medial antebrachial cutaneous nerve pp.521-529
Published Date 2016/5/1
DOI https://doi.org/10.11477/mf.1416200431
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Abstract

Thoracic outlet syndrome (TOS) is a well-known disorder, but many aspects of its pathology, including its definition, has been disputed. True neurogenic TOS (TN-TOS) is a rare but well-defined clinical condition. TN-TOS results from the compression of the C8/T1 roots (dominant for the T1 root) or the proximal lower trunk of the brachial plexus by a fibrous band. The band extends from the first rib to either the tip of an elongated C7 transverse process or a rudimentary cervical rib. The most common presenting symptoms of TN-TOS are insidious-onset atrophy and weakness of the intrinsic hand muscles, predominantly in the thenar eminence and radial digit flexors. Nerve conduction studies demonstrate pathognomonic findings: severely attenuated compound muscle action potential of the abductor pollicis brevis muscle, and usually, loss of the sensory nerve action potential of the medial antebrachial cutaneous nerve. Numbness and sensory loss are typically observed, mainly in the medial forearm, although they are usually mild, and may be absent in some patients. Severe pain or paresthesia proximal to the elbow is not observed. The classical concept of TOS underlie nonspecific neurogenic TOS. It has been primarily diagnosed using provocative maneuvers. However, there is controversy regarding its pathological conceptualization and existence, as objective evidence of the disease is still lacking.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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