Clinical, electrodiagnostic, and sonographic studies in ulnar neuropathy at the elbow
Clinical, electrodiagnostic, and sonographic studies in ulnar neuropathy at the elbow
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DOI：
10.1002/mus.20093
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发表时间：
2004-08-01
期刊：
影响因子：
3.4
通讯作者：
Visser, LH
中科院分区：
文献类型：
--
作者：
Beekman, R;Van Der Plas, JPL;Visser, LH
本研究的目的是确定肘部尺神经病 (UNE) 患者的临床特征、电生理特征和超声尺神经直径之间可能的相关性。我们前瞻性地对 102 名具有纯粹感觉体征 (35%) 或感觉运动体征 (65%) 的 UNE 患者进行了临床、电诊断和超声检查研究。神经传导研究的敏感性为 78%，超声检查的加入将敏感性提高到 98%。两项测试的诊断价值在有和没有运动缺陷的病例中没有差异。通过小指展肌和第一背侧骨间肌记录进行的运动研究对于检测肘部传导阻滞或速度减慢同样敏感，但这种组合比仅进行一项研究产生了更多的阳性病例。电诊断参数和超声尺神经直径之间存在适度的负相关。电诊断和超声检查显示，临床纯感觉和混合感觉运动病例之间没有显着差异，除了电诊断结果表明在有运动体征的病例中运动轴突缺失。几乎一半仅有感觉症状的患者有运动轴突丧失的肌电图证据。我们的结论是，尽管 UNE 具有临床异质性，但尽管临床表现各异，但电生理学和超声检查结果相当一致。
The aim of this study was to determine possible correlations between the clinical characteristics, electrophysiological features, and sonographic ulnar-nerve diameter in patients with ulnar neuropathy at the elbow (UNE). We prospectively performed clinical, electrodiagnostic, and sonographic studies in 102 patients having either purely sensory signs (35%) or sensorimotor signs (65%) of UNE. Nerve conduction studies had a sensitivity of 78%, and the addition of sonography increased this to 98%. The diagnostic value of both tests was not different among cases with and without motor deficit. Motor studies with recording from the abductor digiti minimi and first dorsal interosseous muscles were equally sensitive for the detection of conduction block or velocity slowing across the elbow, but the combination yielded more positive cases than when only one study was performed. There were modest negative correlations between the electrodiagnostic parameters and the sonographic ulnar-nerve diameter. Electrodiagnostically and sonographically, there were no significant differences between clinically pure sensory and mixed sensorimotor cases of UNE, except for electrodiagnostic findings suggesting loss of motor axons in cases with motor signs. Almost half the patients with only sensory signs had electromyographic evidence of motor axonal loss. We conclude that, although UNE is clinically heterogeneous, the electrophysiological and sonographic findings are fairly consistent despite the clinical manifestations.