正中神经返支卡压征的电生理研究

Clinical and electrophysiological study of entrapment syndrome of recurrent branch of median nerve

目的探讨正中神经返支卡压征的临床与电生理特点。方法总结14例正中神经返支卡压征患者的临床与电生理资料,其中男10例,女4例,平均年龄34．7岁,应用肌电诱发电位仪进行神经电生理检测。结果 14例患者正中神经末梢运动潜伏时延长,11例复合肌肉动作电位波幅降低,14例感觉传导速度、感觉动作电位波幅正常,12例前臂段运动传导速度正常;12例拇短展肌、14例拇指对掌肌见纤颤电位和/ 或正锐波;14例旋前方肌、小指展肌与指浅屈肌肌电图检测均正常。结论神经电生理检测是诊断和鉴别诊断正中神经返支卡压征的可靠手段,能为临床提供客观、准确的诊断指标。

Objective To investigate the clinical and electrophysiological characteristics of entrapment syndrome involving the median nerve＇s recurrent branch. Methods Fourteen cases （ 10 male, 4 female, mean age 34.7） of medial nerve recurrent branch entrapment syndrome were retrospectively analyzed in this study with regard to their clinical and eleetrophysiological data. Results Normal sensory conduction velocity （SCV） and normal amplitude of the sensory nerve action potential （SNAP） were found, but there was a delay of the distal motor latency （DML） in all 14 cases. The compound muscle action potential （CMAP） amplitude was decreased in 11 cases, and normal motor conduction velocity （MCV） was demonstrated in 12 cases. Fibrillation potentials and/or positive sharp waves were detected in the abductor pollicis brevis muscle in 12 cases and in the opponens pollicis muscle in 14 cases. EMGs of the flexor digitorum superficialis and pronator quadratus muscle were normal in all 14 cases. Conclusion Electrophysiological examination could provide objective and reliable data for diagnosing and differentially diagnosing median nerve recurrent branch entrapment syndrome.