The most common problems relating to peripheral nerves seen by neurosurgeons are what we call entrapment neuropathies.
As patients age, nerves can be caught or pinched by thickening of tissues as they pass through structures around the body.
In general, entrapment neuropathies can be treated with surgical decompression. In most cases, a minimally invasive surgery will result in complete relief of symptoms.
Carpal Tunnel Syndrome (median neuropathy)
The most common of the entrapment neuropathies, this is where the median nerve is compressed as it passes through a tunnel at the wrist. Patients develop pain, pins and needles and numbness in the hands. The pain generally occurs at night. As the condition progresses it causes weakness of the thumb.
Lateral Popliteal Syndrome
The sciatic nerve divides into two branches just behind the knee. A nerve called the common perineal nerve can become entrapped in fibrous tissue as it passes through a tunnel around the top of the fibula (the small bone of the leg). This can cause pain in the calf and foot and if it becomes severe may cause paralysis of the ankle.
This is entrapment of the lateral cutaneous nerve of the thigh. It can cause an unpleasant burning numbness running down the front of the thigh. The nerve is trapped in a ligament as it descends out of the front of the pelvis.
This is entrapment of the greater occipital nerve at the back of the head as it arises from between the C1 and C2 vertebra. It may be treated by injections or in severe cases by implanting stimuli. Often, this condition is due to arthritis in the upper cervical spine.
Tarsal Tunnel Syndrome
This is similar to carpal tunnel syndrome, although it occurs in the foot. A sciatic nerve becomes entrapped just as it enters the foot.
This is not really an entrapment of the nerve. This is pain in the face, thought to be caused by a blood vessel pressing on the trigeminal nerve inside the skull. The pain can be disabling and brought on by cold, chewing or even gusts of wind.
The ulnar nerve can become compressed as it passes through a tunnel at the elbow. Patients usually complain of pins and needles and pain from the inside of the arm down towards the little finger.