title: Multifocal Neuropathy: Expanding the Scope of Double Crush Syndrome.
abstract: Double crush syndrome (DCS), as it is classically defined, is a clinical condition composed of neurological dysfunction due to compressive pathology at multiple sites along a single peripheral nerve. The traditional definition of DCS is narrow in scope because many systemic pathologic processes, such as diabetes mellitus, drug-induced neuropathy, vascular disease and autoimmune neuronal damage, can have deleterious effects on nerve function. Multifocal neuropathy is a more appropriate term describing the multiple etiologies (including compressive lesions) that may synergistically contribute to nerve dysfunction and clinical symptoms. This paper examines the history of DCS and multifocal neuropathy, including the epidemiology and pathophysiology in addition to principles of evaluation and management.
authors.affiliation: Department of Orthopedics, The Warren Alpert Medical School of Brown University, Providence, RI. Electronic address: bharriscohen@gmail.com.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Cohen
authors.affiliation: The Philadelphia Hand Center, PC, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Gaspar
authors.affiliation: Department of Orthopedics, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Daniels
authors.affiliation: Department of Orthopedics, The Warren Alpert Medical School of Brown University, Providence, RI.
authors.forename: Edward
authors.initials: E
authors.lastname: Akelman
authors.affiliation: The Philadelphia Hand Center, PC, Thomas Jefferson University, Philadelphia, PA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Kane
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D000071576:Crush Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D003444:Crush Syndrome / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D019468:Disease Management; D005260:Female; D006230:Hand Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D009626:Terminology as Topic; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Neuropathy; carpal tunnel; double crush; radiculopathy