Development of entrapment neuropathies in acute stroke patients Introduction Stroke, after heart disease and cancer, is the third most common cause of death in the world, and it is also the most common cause of morbidity among all the neurological diseases. It is known that at least 50% of the neurological diseases in a general hospital are stroke (1). Most of the stroke patients are bedridden, especially in the acute stage of stroke. The major complica- tions of stroke are infections, epileptic seizures, deep venous thrombosis and pulmonary embo- lism (2, 3). Stroke patients may also have predisposition to polyneuropathies and entrap- ment neuropathies because of long stay in bed due to paresis (4). Entrapment neuropathies in stroke patients may worsen the clinical condition and delay the improvement period. The entrap- ment neuropathies in stroke patients may be easily overlooked because of the clinical status of the patients. However there are only a few studies about entrapment neuropathies in stroke patients (4). Entrapment neuropathies usually occur near joints where the nerve passes through a fibrous tunnel as it courses from the body segment to the next (5). The most common entrapment neurop- athies are carpal tunnel syndrome (an injury to the median nerve at the wrist), cubital tunnel syndrome (an injury to the ulnar nerve at the elbow) and peroneal nerve entrapment at the fibular neck (5). Electrodiagnostic evaluation is extremely useful to confirm the clinical diagnosis, to establish the site of the lesion, to assess the feature of the nerve damage, and to predict the prognosis in patients with entrapment neuropa- thies (6). In this study, we evaluated the development of common entrapment neuropathies in the acute (within the first month) stage of stroke. Material and methods Twenty patients (8 men, 12 women) with first ever ischemic or hemorrhagic stroke who were admitted within 24 h after the event were included in the Acta Neurol Scand 2009: 120: 53–58 DOI: 10.1111/j.1600-0404.2008.01122.x Copyright Ó 2008 The Authors Journal compilation Ó 2008 Blackwell Munksgaard ACTA NEUROLOGICA SCANDINAVICA Kabayel L, Balci K, Turgut N, Kabayel DD. Development of entrapment neuropathies in acute stroke patients. Acta Neurol Scand 2009: 120: 53–58. Ó 2008 The Authors Journal compilation Ó 2008 Blackwell Munksgaard. Background – Stroke is the third most common cause of mortality and is one of the most common causes of morbidity in the world. Polyneuropathies and entrapment neuropathies are known as the complications of stroke. Aims of the study – In this study we aimed to evaluate the development of entrapment neuropathies in severe stroke patients within the first month of the event. Methods – Twenty first- ever stroke patients were included in the study. The nerve conduction studies were performed within the first 48 h and repeated 1 month later. Results – At the end of the first month, seven of the 20 patients had median nerve entrapment at the wrist, five had ulnar nerve entrapment at the elbow and seven had peroneal nerve entrapment at the fibular head in the hemiparetic side. Three patients had median nerve entrapment at the wrist, one patient had ulnar nerve entrapment at the elbow, and none had peroneal nerve entrapment in the non- paretic side. Conclusion – Our results confirm that, in severe hemiparetic patients, the entrapment neuropathies may be commonly seen, especially in the paretic extremities. The early rehabilitation programs against the development of entrapment neuropathies may be beneficial in stroke patients. L. Kabayel 1 , K. Balci 1 , N. Turgut 1 , D. D. Kabayel 2 Departments of 1 Neurology and 2 Physical Medicine and Rehabilitation, School of Medicine, University of Trakya, Edirne, Turkey Key words: stroke; entrapment neuropathy; median nerve; ulnar nerve; peroneal nerve Kemal Balci, Department of Neurology, School of Medicine, University of Trakya, 22030 Edirne, Turkey Tel.: +90 284 212 90 62 Fax: +90 284 213 16 31 e-mail: kemalbalcidr@yahoo.com Accepted for publication September 4, 2008 53