Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) refers to symptomatic compression of the median nerve in the wrist as it passes through the carpal tunnel, which is bounded by the carpal bones and…
Mononeuropathy Multiplex
Mononeuropathy multiplex (sometimes referred to as mononeuritis multiplex) is defined as lesions affecting two or more nerves that cannot be explained by a single root or plexus injury. The involvement…
Paraprotein-Associated Neuropathies
Neuropathies associated with monoclonal gammopathies (paraproteinemias) are relatively uncommon. Paraprotein subtypes most frequently associated with polyneuropathy include heavy chains (IgM, IgA, and IgG) and light chains (kappa or lambda). Determining…
Demyelinating Neuropathies
Nerve conduction studies (NCSs) can determine whether a neuropathy is due to injury to the nerve axon (axonal neuropathy) or to the myelin sheath (demyelinating neuropathy). As the number of…
Distal Symmetric Polyneuropathy
Polyneuropathy that involves the distal aspects of the limbs (at least initially) in a symmetric pattern is a common neurologic presentation. Sometimes referred to as a “stocking-glove” distribution, the most…
Electromyography and Nerve Conduction Studies
Electrophysiologic study of the peripheral nervous system typically involves nerve conduction studies (NCS) and needle examination of the muscle (electromyography; EMG). NCS/EMG is useful to localize a lesion (root/plexus/nerve/neuromuscular junction/muscle)…
Treatment of Tics
A. Patients with simple motor tics can sometimes achieve acceptable symptom control with botulinum toxin injections, particularly if the areas injected involve the face (e.g., blinking tics, or tics involving…
Treatment of Dystonia
Dystonia is characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned and twisting, and may be tremulous. Dystonia is…
Treatment of Parkinson’s Disease
A. Aerobic exercise may be neuroprotective, and should be recommended for all Parkinson disease (PD) patients. B. Cognitively intact patients under age 65 years can try a monoamine oxidase type…
Treatment of Essential Tremor
A. Certain patients with mild tremor may only need tremor control for short, specific periods of time (for example, while giving a speech or going to dinner with friends). In…
