Category: Neurologic

Cervical, Diagnostic Skills, Evidence Based Practice, Home, Manual Therapeutics, Neck Pain, Neurologic, Thoracic, Upper Back Pain

Unraveling the Enigma: Rare Brown-Sequard Syndrome Arising from Cervical Disc Herniation

Brown-Sequard Syndrome, as delineated in 1849 by Brown-Se´quard CE, emanates from trauma inflicted upon the anatomical hemicord. This trauma precipitates disruption of the descending lateral corticospinal tracts, the ascending dorsal columns (both of which decussate in the medulla), and the ascending lateral spinothalamic tracts, which intersect within one or two levels of the dorsal root entry. While total hemisection, evoking the hallmark clinical features of … Continue reading Unraveling the Enigma: Rare Brown-Sequard Syndrome Arising from Cervical Disc Herniation

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Diagnostic Accuracy, Diagnostic Agreement, Diagnostic Efficiency, Diagnostic Skills, Evidence Based Practice, Home, Lower Back Pain, Lumbar, Manual Therapeutics, Neurologic

Neurological bedside examination: accuracy in lumbo-sacral radiculopathy

In Western industrialised countries, low-back pain (LBP) is a common cause of disability. Although many people have at least one episode of low-back pain throughout their lives, no identifiable disease is found in up to 85% of patients (Deyo et al. 1992). Low back-related leg pain, which accounts for 23% to 57% of all LBP cases (Scharfer A, et al. 2007). In patients who report … Continue reading Neurological bedside examination: accuracy in lumbo-sacral radiculopathy

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Arms, Back, Clinical Tests, Legs, Neurologic

Neurodynamic Assessment

A neurodynamic test checks the length, mobility and mechanical sensitivity of the neurological tissues (1). For a neurodynamic test to be positive, the limb/joint positioning sequence should reproduce the patient’s symptoms associated with radiculopathy along with/without a measurable asymmetry between left and right sides. A positive neurodynamic test indicates multiple pathogeneses, which may include increased tension in the dura mater and the nerves, compression on … Continue reading Neurodynamic Assessment

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Evidence Based Practice, Home, Manual Therapeutics, Neurologic, Research Questions

Pathophysiology of entrapment neuropathies

This blog summarises the available evidence on the influence of entrapment neuropathies on the anatomical and physiological features of the peripheral nervous system that have previously been discussed. Let’s get started! Entrapment Neuropathies and Ischaemia Entrapment neuropathies are hypothesised to disrupt intraneural blood flow by reversing the pressure gradient required for optimal blood supply. Extraneural pressures as low as 20–30 mmHg interrupt intraneural venous circulation, … Continue reading Pathophysiology of entrapment neuropathies

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Back, Home, Lower Back Pain, Lumbar, Manual Therapeutics, Neurologic

Spinal manipulation and mobilization in the right direction: part 2

Finding the best way to manipulate or mobilize the spine in patients with severe radiculopathies can be difficult for many physiotherapists. There are two ways to determine the right direction. The first is the H-reflex approach, which Mohamed Sabahhi described (Abdulwahab and Sabbahi, 2000; Ali Ashraf and Sabbahi, 2001; Ali and Sabbahi, 2000), Another one is the Robin McKenzie-described pre-manipulative testing (McKenzie R 1981). Both … Continue reading Spinal manipulation and mobilization in the right direction: part 2

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