Double Crush Syndrome: Difference between revisions
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== Evidence == | == Evidence == | ||
#Experimental research by Nemoto et al., found evidence for double crush syndrome and concluded that two low grade compressions along a nerve are worse than either alone.<br> | #Experimental research by Nemoto et al., found evidence for double crush syndrome and concluded that two low grade compressions along a nerve are worse than either alone.<br> | ||
#In a study of 1,000 patients with carpal tunnel syndrome, Hurst et al., found a statistically significant incidence of bilateral carpal tunnel syndrome in patients with cervical spondylosis. They also found a relationship between diabetic neuropathy and this type of nerve entrapment phenomenon.<br> | |||
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== References == | == References == |
Revision as of 20:33, 1 May 2014
Introduction[edit | edit source]
- The double crush hypothesis was first formulated in 1973 and states that axons that have been compressed at one site become especially susceptible to damage at another site.
- This theory was originally described by Upton (1973) in a study of 115 patients.
- The existence of double crush syndrome was further substantiated by Massey's (1981) study of nineteen cases of carpal tunnel syndrome co-existing with a cervical radiculopathy.
Hypothesis[edit | edit source]
- It is suggested that compression of an axon at one location makes it more sensitive to effects of compression in another location,because of impaired axoplasmic flow.
- Hypothetically, two lesions with little or no independent clinical ramifications, when combined, lead to appearance or magnification of symptoms
- Two areas of compression affecting the same axons do not, alone, meet the criteria of the hypothesis.
- By definition, a first lesion must render axons more susceptible to effects of a second, leading to more than just the combined, independent effects of two lesions
- Upton and McComas used the double crush hypothesis to explain why patients with carpal tun-nel syndrome (CTS) sometimes feel pain in the forearm, elbow, upper arm, shoulder, chest, and upper back.
- They also used it to explain failed attempts at surgical repairs when neither surgery nor CTS diagnosis appeared faulty.
- They claimed that most patients with CTS not only have compressive lesions at the wrist, but also show evidence of damage to cervical nerve roots.
Evidence[edit | edit source]
- Experimental research by Nemoto et al., found evidence for double crush syndrome and concluded that two low grade compressions along a nerve are worse than either alone.
- In a study of 1,000 patients with carpal tunnel syndrome, Hurst et al., found a statistically significant incidence of bilateral carpal tunnel syndrome in patients with cervical spondylosis. They also found a relationship between diabetic neuropathy and this type of nerve entrapment phenomenon.