Median nerve entrapment syndromes: current approaches to diagnosis and therapy

Currently, research into compression neuropathies of the upper limbs is of great importance in the fields of neurology, orthopedics, and rehabilitation medicine. Particular attention is paid to pathologies affecting the median nerve, which is crucial for ensuring precise hand movements and sensitivity of the palmar surface of the fingers. In the case of significant prolonged nerve compression or prolonged lack of adequate treatment, the risk of persistent neurological deficit increases.

Purpose of the literature review. To systematize scientific publications and clinical studies focusing on compression neuropathy of the median nerve (pronator teres syndrome and carpal tunnel syndrome).

Analysis of sources suggests that the prognosis for conditions such as pronator teres syndrome and carpal tunnel syndrome depends on several key factors. First and foremost,itisimportanthowquicklyacorrect diagnosiscanbeestablished. Oneofthemain findings is the assessment of the role of electroneuromyography (ENMG) in the diagnosis of compression neuropathies. It is worth noting that ENMG in the early stages of neuropathy does not always provide complete information about the patient’s condition. Normal ENMG results in the initial stages of carpal tunnel syndrome or in dynamic forms of the disease cannot serve as grounds for ruling out the diagnosis. In such cases, other diagnostic methods may be more valuable, such as ultrasound neurography and ENMG performed using extended protocols – these enhance the accuracy and informativeness of the examination. When nerve compression is detected early, it is often possible to completely eliminate symptoms using conservative treatment methods. However, if the nerve has undergone significant compression or the patient has not received proper care for a long time, there is a risk of nerve fiber degeneration. Surgical decompression is typically resorted to in two cases: when conservative methods have not produced the desired effect, or when the degree of nerve compression is too severe.

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