{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T23:06:22Z","timestamp":1748905582979,"version":"3.28.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2024,2]]},"abstract":"Zusammenfassung<\/jats:title>\n Hintergrund\u2002 Die Neuralgische Amyotrophie (NA) ist eine mono- bzw.\n oligofokale entz\u00fcndliche Neuropathie, deren Inzidenz deutlich\n untersch\u00e4tzt wurde. Ein Zusammenhang von Konstriktionen und Torsionen an\n peripheren Nerven mit dieser Erkrankung konnte in den letzten Jahren zunehmend\n hergestellt werden. Moderne bildgebende Verfahren wie hochaufl\u00f6sender\n Nervenultraschall und die MR-Neurographie haben dazu beigetragen, die\n Pathophysiologie besser zu verstehen und die Prognose der Erkrankung besser\n einsch\u00e4tzen zu k\u00f6nnen. Daraus hat sich das Konzept entwickelt,\n Patienten mit solchen fokalen Ver\u00e4nderungen einer operativen Therapie\n zuzuf\u00fchren, um die Prognose zu verbessern. Die folgende Arbeit stellt\n aktuelle Vorstellungen zu Pathophysiologie, Klinik und Diagnostik und Therapie\n der Erkrankung dar.<\/jats:p>\n Patienten und Methoden In einer retrospektiven Studie wurden die\n pr\u00e4-, intra- und postoperativen Befunde bei 22 Patienten mit 23\n Konstriktionen\/Torsionen an peripheren Nerven der oberen\n Extremit\u00e4t analysiert. Die Patienten wurden in einem Zeitraum von 3,5\n Jahren (Dez. 2019\u2013Mai 2023) in einem nervenchirurgischen Zentrum\n operiert. Am h\u00e4ufigsten war der N. medianus (N=9), gefolgt von\n N. suprascapularis (N=6) und N. radialis (N=4) betroffen. Ferner\n waren der N. axillaris (N=3) und der N. accessorius (N=1)\n beteiligt. Bei der operativen Exploration fanden sich Nerventorsionen\n (N=9), Nervenkonstriktionen (N=5), faszikul\u00e4re Torsionen\n (N=12) und faszikul\u00e4re Konstriktionen (N=9). Je nach\n intraoperativem Befund wurden Epineuriotomien (N=1), Epi- und\n Perineuriotomien (N=33), End-zu-End-N\u00e4hte (N=2), und je\n eine epi- und perineurale Naht vorgenommen.<\/jats:p>\n Ergebnisse Nach einer Nachbeobachtungszeit von durchschnittlich 10 Monaten\n (3-28 Monate) gaben alle 17 erneut untersuchten Patienten eine eindeutige\n subjektive Besserung der motorischen Ausf\u00e4lle an. Klinisch und\n elektromyographisch konnte bei diesen Patienten eine Reinnervation und deutliche\n Kraftzunahme von einem vorbestehenden Kraftgrad M0 zu mindestens M3, in der\n \u00fcberwiegenden Mehrheit der betroffenen Muskeln nachgewiesen werden.<\/jats:p>\n Zusammenfassung Die NA ist eine Erkrankung, deren Inzidenz weiterhin\n untersch\u00e4tzt wird und die bei einem erheblichen Anteil der Patienten zu\n permanenten motorischen Defiziten f\u00fchrt, die mit hoher\n Wahrscheinlichkeit Konstriktionen und Torsionen der betroffenen Nerven\n geschuldet sind. Eine m\u00f6glichst fr\u00fchzeitige operative Therapie\n dieser Patienten ist zu empfehlen. Mit einer Epi- und Perineuriotomie\n k\u00f6nnen in der Regel sehr gute Ergebnisse erzielt werden. In seltenen\n F\u00e4llen sind eine End-zu-End-Naht oder eine autologe Transplantation\n erforderlich.<\/jats:p>","DOI":"10.1055\/a-2226-4260","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T23:40:30Z","timestamp":1706226030000},"page":"40-48","source":"Crossref","is-referenced-by-count":3,"title":["Neuralgische Amyotrophie \u2013 eine entz\u00fcndliche\n Neuropathie und ihre operative Behandlung"],"prefix":"10.1055","volume":"56","author":[{"given":"Peter","family":"P\u00f6schl","sequence":"additional","affiliation":[{"name":"Neurologie, Neurologische Praxis Sinzing, Sinzing,\n Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirko","family":"Pham","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Neuroradiologie, Universit\u00e4t\n W\u00fcrzburg, Wurzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Pedro","sequence":"additional","affiliation":[{"name":"Neurochirurgie, Bezirkskrankenhaus G\u00fcnzburg, G\u00fcnzburg,\n Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Antoniadis","sequence":"additional","affiliation":[{"name":"Neurochirurgie, Bezirkskrankenhaus G\u00fcnzburg, G\u00fcnzburg,\n Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"ref1","first-page":"617","article-title":"Isolated paralysis of the deep branch of the radial nerve thought to be the\n entrapment neuropathy (in Japanese)","volume":"1","author":"T Abe","year":"1966","journal-title":"Rinsho Seikei Geka"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1093\/brain\/awh722","article-title":"The clinical spectrum of neuralgic amyotrophy in 246 cases","volume":"129","author":"N van Alfen","year":"2006","journal-title":"Brain"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/s0140-6736(48)90611-4","article-title":"Neuralgic amyotrophy; the shoulder-girdle syndrome","volume":"1","author":"M J Parsonage","year":"1948","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/brain\/123.4.665","article-title":"The incidence and lifetime prevalence of neurological disorders in a prospective\n community-based study in the UK","volume":"123","author":"B K Mac Donald","year":"2000","journal-title":"Brain"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"e0128361","DOI":"10.1371\/journal.pone.0128361","article-title":"Incidence of neuralgic amyotrophy (Parsonage Turner syndrome) in a primary care\n setting\u2014a prospective cohort study","volume":"10","author":"N van Alfen","year":"2015","journal-title":"PLoS One"},{"key":"ref6","first-page":"113","article-title":"Radialis-Kompressionssyndrome","volume":"8","author":"A Wilhelm","year":"1976","journal-title":"Handchirurgie"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/jnnp-2020-323164","article-title":"Neuralgic amyotrophy: a paradigm shift in diagnosis and treatment","volume":"0","author":"C Gstoettner","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1212\/WNL.0000000000000112","article-title":"Neuralgic amyotrophy and hepatitis E virus infection","volume":"82","author":"J J van Eijk","year":"2014","journal-title":"Neurology."},{"key":"ref9","first-page":"e41001","article-title":"Clinical Spectrum of Postsurgical Parsonage-Turner Syndrome: A Perspective From\n an Electrodiagnostic Laboratory","volume":"15","author":"V G Iyer","year":"2023","journal-title":"Cureus."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1755","DOI":"10.1212\/WNL.0b013e3181a609e3","article-title":"Brice. 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