Peripheral Nerve Conditions
Nerve signals begin in our brains and travel down our spinal cords, but it is the peripheral nerves that bring the signals to our muscles and bring our bodies to life. Nerves anywhere in the body can be affected by compression, tumors, or injuries such as lacerations. Although Dr. Hatef treats all types of peripheral nerve conditions, some of the more common ones are discussed below.
Nerve Compression
The most common nerve condition is compression, also called entrapment. As nerves course throughout the body, there are known positions along the nerve where they are more susceptible to injury. Often, with age, nerves become entrapped at these locations. Surgery to decompress the nerve and remove any tissue that is irritating or compressing it is often very effective at alleviating symptoms.
A carpal tunnel decompression surgery.
Carpal tunnel syndrome is the most common nerve condition and the most common nerve entrapment. The median nerve is compressed as it travels from the wrist into the hand. Symptoms include weakness, numbness, and tingling in the thumb and first two fingers. Although bracing and injections can help with mild cases, surgery is very effective at relieving symptoms and preventing nerve damage.
Cubital tunnel syndrome is another common nerve entrapment involving the ulnar nerve as it courses around the elbow. It causes symptoms primarily in the opposite fingers as carpal tunnel: the ring and little fingers are affected the most.
Radial tunnel syndrome is caused by entrapment of the radial nerve, or one of its branches, near the front of the elbow. It can cause pain near the outside of the elbow and weakness of the muscles controlling the wrist.
Thoracic outlet syndrome refers to compression of the brachial plexus in the neck. It can cause symptoms of neck and shoulder blade pain, as well as pain and weakness of the hand
A nerve conduction study has diagnosed slowing of nerve signals in the median nerve. This patient has moderate carpal tunnel syndrome.
Dr. Hatef works with a team of neurologists to diagnose and treat nerve entrapments. In patients with nerve symptoms, a nerve conduction study is usually obtained. Also referred to as a needle study or EMG/NCS, nerve studies allow us to identify nerve injury and grade the severity of the condition. Many patients with mild symptoms can have improvement with bracing, injections, or physical therapy to improve posture. Patients with more severe symptoms benefit from surgery.
Nerve Tumors
Tumors affecting peripheral nerves are rare but can be quite disabling. Typically they are benign tumors - most commonly schwannomas - but as they grow they can compress nerves, causing significant pain and even weakness or numbness. Although some nerve tumors can be observed, most benefit from surgical resection, especially if they are large. Dr. Hatef has experience with tumors involving nerves all over the body.
Neurofibroma of the brachial plexus. This was removed through a small neck incision.
Schwannoma of the common peroneal nerve causing severe knee and leg pain.
Large tibial schwannoma behind the knee joint.
Nerve Injuries
Nerve can be injuries from nearly anything - car accidents, broken glass, falls, or gunshots. Although some nerve injuries improve on their own, many patients benefit from surgery to repair nerve and help restore function. Dr. Hatef treats nerve injuries with both direct repair and nerve transfer procedures.