References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2025-308

medsovet-9311

Research Article

ЗАБОЛЕВАНИЯ ПЕРИФЕРИЙНОЙ НЕРВНОЙ СИСТЕМЫ

PERIPHERAL NERVOUS SYSTEM DISEASES

Туннельные невропатии нервов рук: клинические симптомы и тактика лечения

Entrapment neuropathies of the arm nerves: Clinical symptoms and therapeutic approaches

https://orcid.org/0000-0002-7384-6715

Ахмеджанова

Л. Т.

Akhmedzhanova

L. Т.

Ахмеджанова Луиза Талгатовна - к.м.н., доцент кафедры нервных болезней и нейрохирургии Института клинической медицины имени Н.В. Склифосовского.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Louiza Т. Akhmedzhanova - Cand. Sci. (Med.), Associate Professor of the Department of Nervous Diseases and Neurosurgery at the N.V. Sklifosovsky Institute of Clinical Medicine.

8, Bldg. 2, Trubetskaya St., Moscow, 119991

akhmedzhanova_l_t@staff.sechenov.ru

https://orcid.org/0009-0002-3020-5704

Щербанина

В. Ю.

Shcherbanina

V. Yu.

Щербанина Вероника Юрьевна - к.м.н., врач функциональной диагностики Университетской клинической больницы №3.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Veronika Yu. Shcherbanina - Cand. Sci. (Med.), Doctor of Functional Diagnostics at University Clinical Hospital No. 3.

8, Bldg. 2, Trubetskaya St., Moscow, 119991

https://orcid.org/0009-0000-0199-2919

Солдатенкова

А. Ю.

Soldatenkova

A. Yu.

Солдатенкова Арина Юрьевна – студент.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Arina Yu. Soldatenkova – Student.

8, Bldg. 2, Trubetskaya St., Moscow, 119991

soldatenkovaa564@gmail.com

Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation

2025

08082025

012101108

2025

Ахмеджанова Л.Т., Щербанина В.Ю., Солдатенкова А.Ю.

Akhmedzhanova L.Т., Shcherbanina V.Y., Soldatenkova A.Y.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/9311

Туннельные невропатии представляют собой распространенную группу заболеваний периферической нервной системы, развивающихся вследствие компрессии нервных стволов в анатомически узких каналах. В статье рассмотрены основные варианты компрессионных невропатий нервов рук, клинические симптомы, диагностические тесты и тактика лечения. Клинические проявления при туннельных невропатиях варьируют в зависимости от уровня компрессии и степени поражения нерва. Инструментальная диагностика включает в себя электронейромиографию, а также методы визуализации – УЗИ и МРТ, которые особенно ценны для дифференциальной диагностики и выявления структурных изменений как самого нерва, так и окружающих мягких тканей. Лечение туннельных невропатий зависит от стадии заболевания. На начальной стадии показана консервативная терапия: ортезирование, локальное введение кортикостероидов и модификация физической активности. При неэффективности консервативной терапии, наличии двигательных нарушений, стойких невропатических болях рекомендуется хирургическое лечение, направленное на декомпрессию нервного ствола. В комплексной терапии туннельных невропатий на любом этапе заболевания целесообразно включать высокодозные витамины группы В, оказывающие нейрометаболический эффект и способствующие регенерации поврежденных нервов. Прогноз заболевания зависит от своевременной диагностики и адекватной терапии. Раннее начало лечения позволяет достичь полного восстановления функции нерва, тогда как длительная компрессия может привести к необратимым изменениям, включая стойкие двигательные нарушения и атрофию мышц.

Entrapment neuropathies are a common group of peripheral nervous system disorders that develop due to compression of nerve trunks as they pass through anatomically narrow canals. The article discusses the main types of compression neuropathies of the arm nerves, clinical symptoms, diagnostic tests and therapeutic approaches. Clinical manifestations of entrapment neuropathies fluctuate based on the level of compression and the degree of nerve injury. Diagnostic tools include electroneuromyography and visualization methods such as ultrasound and MRI, which are particularly valuable for differential diagnosis and detection of structural changes in the nerve itself and its surrounding soft tissues. Treatment of entrapment neuropathies depends on the stage of the disease. Initial treatment is conservative and may include orthotics, local administration of corticosteroids and modification of physical activities. If conservative therapy is ineffective and patients show movement disorders, persistent neuropathic pain, surgical treatment aimed at decompressing the nerve trunk is recommended. It is advisable to include highdose B vitamins in the complex therapy of entrapment neuropathies at any stage of the disease, as they have neurometabolic effects and promote the regeneration of injured nerves. The prognosis of the disease is based on timely diagnosis and adequate therapy. Early treatment allows complete nerve function recovery, while prolonged compression can lead to irreversible changes, including persistent motor impairments and muscle atrophy.

туннельные невропатиисиндром запястного каналасиндром кубитального каналаневропатия лучевого нервасиндром круглого пронаторасиндром канала Гийонавитамины группы Внейромультивит

tunnel neuropathiescarpal tunnel syndromecubital canal syndromeradial nerve neuropathyround pronator syndromeGuyon canal syndromeB vitaminsneuromultivitis

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The authors declare that there are no conflicts of interest present.