Peripheral Nerve Disorders

Nerve conduction studies and EMG studies have an important role in the diagnosis and assessment of peripheral nerve disorders such as nerve entrapments, nerve injuries, and other peripheral nerve disorders. Dr. Akhtar and his team of physiologists are highly trained and well experienced in the diagnosis of peripheral nerve disorders.

Nerve Entrapments

Nerve entrapment is a condition that develops when a peripheral nerve losses flexibility, mobility, or becomes compressed (entrapped) or restricted by surrounding tissues. Nerve entrapment can cause neurogenic/neuropathic pain that can be acute or chronic. To diagnose this condition adequately, it is important to know the neural pathways, as well as areas of responsibility and supply of the peripheral nerves.

The symptoms of nerve entrapment may vary. Commons symptoms of nerve entrapments are pain, usually in the area of the compressed nerve, but this may also radiate outward. Numbness, paraesthesia (pins and needles), or tingling sensations in the region where the nerve supplies, with or without activity involving the affected nerve. Muscle weakness can also be a symptom.

Nerve conduction studies are paramount in the diagnosis and assessment of peripheral nerve disorders such as nerve entrapments, nerve injuries, and other nerve disorders. Dr. Akhtar is an expert in carrying out nerve conduction studies in Glasgow, Scotland. He and his highly skilled team can accurately evaluate the presence and severity of the nerve entrapments and also if conservative, wait and watch policy or performing surgery would be the best approach in managing the condition.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a very common condition. It is caused when one of the main nerves involved in the function of the hand, called the median nerve, is entrapped or affected by external pressure at the level of the wrist where the nerve enters the hand through a tunnel called carpal tunnel. Entrapment or pressure on the nerve at this site causes patients to experience various symptoms, and the condition is called carpal tunnel syndrome.

The main symptoms include experiencing numbness and pins and needles involving the thumb, index, middle, and ring fingers. These symptoms can be worse first thing in the morning or can wake up patients from sleep at night. Certain positions such as holding a phone or a book can make hands feel numb. When the condition is severe, patients can experience weakness in the handgrip and if sufficiently advanced the condition can also lead to significant loss of muscle and deterioration in the function of the hand and handgrip.

There are varying grades of severity of carpal tunnel syndrome. Certain conditions such as diabetes can predispose patients to the condition and progression to severe dysfunction. Patients with advanced age groups are also at higher risk of significant and early progression of the condition leading to loss of muscle and function.

Early diagnosis of carpal tunnel syndrome, assessment of its severity and timely management can prevent significant progression of the condition and loss of muscle and function. Nerve conduction studies are very sensitive tests in accurately diagnosing carpal tunnel syndrome. The test is also very valuable in accurately assessing the severity and grade of carpal tunnel syndrome. This informs hand surgeons and helps them make important decisions regarding the management of the condition, such as the need for surgical decompression of the nerve versus conservative management such as using wrist splints.

Ulnar Nerve Entrapment

. The ulnar nerve is one of the three main nerves in the upper limbs. Symptoms related to Ulnar nerve can commonly occur when the ulnar nerve in the arm is compressed or entrapped. This nerve after originating from a network of nerves called brachial plexus at the shoulder level, travels down into the hand, and crosses the side of elbow and the wrist along its route. Along the way, it can be constricted or compressed at the wrist or at the elbow. The ulnar nerve is commonly entrapped at the elbow at the cubital tunnel and is often referred to as Cubital Tunnel Syndrome. After carpal tunnel syndrome, ulnar nerve entrapment at the elbow is the second most common entrapment neuropathy. Ulnar nerve related symptoms can occur due to entrapment at the elbow or the wrist, but can also occur due to repetitive external pressure, compression or stretch, often from consistently leaning on the elbows or wrists or and prolonged bending of the elbow. Ulnar nerve can also be injured due to trauma and fractures.

The common symptoms include tingling and numbness in the hand and little and ring fingers. If advanced, the symptoms can include loss of muscle and weakness of handgrip. The severity of Ulnar nerve entrapment can vary. It can be mild or moderate presenting with intermittent symptoms, and it can also be severe and present with persistent symptoms. In less severe cases, symptoms can often be managed with conservative (non-surgical) management such as bracing and splinting or changes in activities such as avoiding pressure on elbows. In sufficiently advanced and more severe cases, surgical exploration and decompression can be required to release the nerve, especially if conservative (nonsurgical) management does not improve the symptoms or if the nerve compression is causing nerve damage or muscle weakness.

Dr. Akhtar and his team of physiologists in Glasgow, Scotland are well experienced in nerve conduction studies and accurately diagnosing and assessing the severity and prognosis of ulnar nerve related problems and entrapments. Early diagnosis and assessment of severity can inform surgeons whether surgery will be needed and this can prevent potential progression and damaged.

Peroneal Nerve Entrapment

Peroneal nerve is one of the main branches stemming from sciatic nerve, providing sensation to the front and outer side of the leg and top of the foot. Peroneal nerve also controls the muscles in the leg, which are responsible for lifting the ankle and toes upward. Injury, compression or entrapment of the nerve can cause numbness, pain, tingling in the area supplied and also weakness in lifting of the foot, which is also referred to us called foot drop.

The common causes of peroneal nerve dysfunction include entrapment around the knee region, repeated stretching of the nerve due to crossing the legs for long periods, the pressure on the nerve while sleeping in awkward position during sleep, and wearing tight high boots regularly, injury or trauma to the knee, fracture to the lower leg bone (fibula), surgical procedures to the knee.

Certain underlying medical conditions like diabetes and excessive weight loss due to any cause including suffering from anorexia nervosa can predispose to common peroneal nerve dysfunction. Other nerve conditions such as mono-neuritis multiplex, autoimmune disorders and more generalised nerve disorders including inherited nerve disorder can also predispose to common peroneal nerve dysfunction.

At NM-Testing, in Glasgow, Scotland and United Kingdom, Dr. Akthar is an expert in conducting the Nerve Conduction Studies, which measures the amount and speed of conduction of electrical impulses through the nerve, and EMG tests which measures the muscle activity in the muscles supplied by peroneal nerve and together these tests can accurately assess degree of peroneal nerve dysfunction as well as level and degree of peroneal nerve injury, providing useful diagnostic and prognostic information

Nerve Injuries

Nerves in a similar way to the electrical wires carry messages in the form of electrical impulses between the brain and the rest of the body. Motor nerves are responsible to carry electrical impulses from the brain to the muscles to make the body parts to move. Other nerves, like the sensory nerves, carry electrical impulses and signals of pain, temperature, touch and pressure from various parts of the body to the brain. Nerves are composed of many nerve fibres called axons. Nerve fibres are encased by a coating, which helps in speeding up the transmission of electrical impulses through the nerve fibres. Various mechanisms including stretching, pressure or direct trauma can cause the injury to the nerves. Nerve injuries can vary in severity ranging from mild, moderate and severe and also ranging from injury to the outer coating of the nerves and/or the nerve fibres within the nerves and even break in the continuity of the nerve in severe cases. Nerve injuries may interfere with the ability of the nerve to receive or send signals. Stretch injuries can range from mild to moderate, or to severe injuries. This can depend on the mechanism of injury. In addition, the extent of nerve injuries can vary from involving a single peripheral nerve, multiple nerves or to the network of nerves i.e. nerve plexus. Symptoms and extent of dysfunction can depend upon the severity of nerve injury and site and extent of nerve injury. Prognosis of nerve injuries can depend on the site and extent of nerve injury, the severity of the nerve injury, and the type of nerve injury.T

EMG and nerve conduction studies play a very important role in accurately diagnosing nerve injuries. These tests also help to assess the severity of the nerve injuries, prognosis of nerve injuries and most importantly about the continuity of nerve. This can inform surgeons and helps them make important decisions regarding the treatment or management of the nerve injuries including decisions if surgical exploration and reconstruction surgery would be required. Dr Akhtar and his team is an expert in accurate diagnosis of nerve injuries in Glasgow, Scotland.

Peripheral Neuropathies

Peripheral nerve disorders, often referred to as peripheral neuropathy can be inherited or acquired during life. Peripheral neuropathic disorders can also be divided into axonal or demyelinating type of neuropathies depending on, if the disorder primarily affects nerve fibres or the outer coating. EMG studies and nerve conduction studies play an important role in the assessment and diagnosis of peripheral nerve disorders and neuropathies. Dr. Akthar is highly specialised and well experienced and highly trained in diagnosing peripheral neuropathic disorders accurately.

Inherited Peripheral Neuropathies

Inherited peripheral neuropathies are inherited disorders that affect the peripheral nerves. Inherited neuropathies can be classified as axonal, demyelinating or mixed variety hereditary neuropathies. These refer to a group of disorders that may lead to weakness and muscle wasting, often in the hands and below the knees and sensory symptoms such as numbness in the upper and lower limbs. The genetic defect for some but not all of these conditions are known, and genetic tests available for diagnosis and prognosis of the conditions. Two common examples of inherited neuropathies include Hereditary Neuropathy with Liability to Pressure Palsies (HNPP), and Charcot-Marie Tooth Disease (CMT).

The symptoms of inherited neuropathies are often similar. Most common symptoms include pain, numbness, or tingling often in the feet and hands. Loss of muscle mass (muscle atrophy) and muscle weakness often in the hands and lower legs and feet. Hammer-shaped toes, high foot arches, or a curved spine (scoliosis) can be associated with inherited peripheral neuropathies.

Dr. Akhtar is highly trained in carry out nerve conduction studies and Electromyography to assess ability of nerves to conduct an electrical signal. This helps us to identify the inherited neuropathies and their type.

Acquired Peripheral Neuropathies

Peripheral neuropathies can also be acquired during life. The causes of acquired peripheral neuropathy may include diabetes, autoimmune disorders, toxins, alcohol, nutritional deficiencies including vitamin deficiencies, metabolic disorders, and vascular disorders. These can also be part of a wider systemic disease.

The symptoms of acquired peripheral neuropathies may include tingling, numbness, and prickling sensations, or sensitivity to touch burning pain (often at night). Others may have muscle weakness, and muscle wasting, or organ dysfunction.

We conduct nerve conduction studies and EMG tests to diagnose acquired peripheral neuropathies in Glasgow, Scotland. These tests are very sensitive and help in accurately diagnosing acquired peripheral neuropathies. This can inform informs neurologist and helps them make important decisions regarding the plan of treatment or management of the neuropathies.

Axonal Type Peripheral Neuropathies

Axonal type neuropathies are characterised by damage to a nerve fibres of nerves, which are called axons. These are extensions of neurons (nerve cells) that transmit impulses. In people with axonal peripheral neuropathies, the nerve damage can cause progressive wasting and weakness of muscles in the legs, feet, and hands, weakness, difficulties in walking, joint deformities in the feet and hands, and falls. In some people with axonal neuropathy, there is decreased sensitivity to touch, pain, cold, or heat, particularly in the lower legs and arms. The common symptoms often include numbness, tingling, and pain in the arms and lower legs.

Systemic diseases can be a cause of axonal neuropathies, conditions like vitamin B12 deficiency, diabetes-related neuropathy, and others could be a cause.

Nerve conduction studies are paramount in diagnosing peripheral neuropathies and categorising and documenting that an axonal type of neuropathy exists. Nerve conduction studies along with Electromyography, helps to detect the severity and distribution of the neuropathy. At NM-Testing, you can depend on Dr Akhtar and his team for reliable diagnosis of all types of peripheral neuropathies including axonal peripheral neuropathies in Glasgow, Scotland.

Demyelinating Type Peripheral Neuropathies

Demyelinating type peripheral neuropathies are characterised by damage to the outer coating of the nerves. These in their clinical characteristics are remarkably varied. These can be acquired or inherited. In their time course, these may be chronic or acute, and in distribution these can be generalized or multifocal.

Although not all signs and symptoms may be present, the common include fatigue, tingling, pain, numbness, loss of reflexes, and weakness. The degree of symptoms can vary in severity in individuals. It may take months or even a year for severe symptoms to appear.

Acquired demyelinating peripheral neuropathies can be due to inflammation in the nerves. Conditions like Guillain-Barre syndrome (GBS) and Chronic Inflammatory demyelinating Polyneuropathy (CIDP) are examples of inflammatory neuropathies. Often demyelinating type peripheral neuropathies if acquired can be amenable to treatment and reduce the burden of disease and extent of disability greatly. Electrophysiologic studies are an important investigatory tool that play a pivotal role in the evaluation of patients with suspected demyelinating neuropathies.

At NM-Testing, using nerve conduction studies and electromyography, we diagnose conditions like Guillain-Barre syndrome ( GBS) and CIDP and other demyelinating and inflammatory neuropathies. At our clinic in Glasgow, Scotland, Dr. Akthar conducts relevant diagnostic tests like nerve conduction studies, and electromyography to detect peripheral neuropathies including demyelinating neuropathies. Early diagnosis can help neurologists to investigate causes of such neuropathies and design a proper plan of treatment for affected patients. Early management and timely treatment of these conditions can prevent reduce and prevent disability.