尺神经肘部病变患者的神经电生理定位诊断特征

The electrophysiological features for localizing ulnar neuropathy at the elbow

目的探讨神经电生理检查对尺神经肘部损害患者的定位诊断价值。方法应用常规的神经电生理检测法:包括尺神经运动传导、尺神经小指-腕感觉神经传导、尺神经支配肌肉的肌电图;特殊检测法:短节段性神经传导检测法,共检测了21例经临床诊断并进一步做神经电生理检查以确诊尺神经肘部病变的患者,与同期30例正常对照组进行比较。短节段性神经传导检测法重点检测尺神经运动传导肘上至肘下段,以寻找其具体损害部位。结果①尺神经病变组中有19例出现尺神经在肘上至肘下段运动神经传导速度减慢;②尺神经肘上至肘下段短节段性神经传导检测结果显示具体病变部位多数集中在肱骨内上髁上下2-3 cm内;③尺神经在肘部病变者并非均有尺侧腕屈肌肌电图的异常。结论短节段性神经传导检测法在确定尺神经在肘部的具体损害部位时有较高的定位诊断价值,而常规的尺神经感觉传导及肌电图异常能协助诊断。

To explore the diagnostic values of electrophysiological studies in localizing ulnar neuropathy at the elbow. Methods Totally 21 patients suspected with ulnar neuropathy at the elbow clinically underwent routine electrodiagnostic tests for the confirmative diagnosis, and contrasted with 30 healthy subjects. Routine electrodiagnostic tests included ulnar motor nerve conduction, ulnar sensory nerve conduction from digit 5 to wrist, ulnar innervated muscle electromyography, and a special test., short-segment nerve conduction study. In order to localize ulnar neuropathy at the elbow, special attention was focused on ulnar motor nerve conduction across the elbow using short-segment nerve conduction study. Results ① Nineteen patients were found ulnar motor nerve conduction slowing across the elbow.② Short-segment ulnar nerve conduction studies showed that most of the lesions were located above or below the medial epicondyle 2--3 cm. ③ Abnormal flexor carpi ulnaris muscle electromyography was not found involved in ulnar neuropathy at the elbow. Conclusion Short-segment nerve conduction studies have a high diagnostic value in identifying the site of lesion in ulnar neuropathy at the elbow, and abnormal ulnar digit 5 to wrist sensory nerve conduction and abnormal electromyography finding may aid in diagnosis.