神经电生理检查对第一背侧骨问肌萎缩的诊断价值

The diagnostic value of neuro-electrophysiological examination for the first dorsal interosseous muscle atrophy

目的探讨神经电生理技术对第一背侧骨间肌萎缩患者的临床诊断及鉴别诊断价值。方法自2015年1月至2017年5月，我们对48例（51侧）无明确外伤史而出现第一背侧骨问肌萎缩的患者进行神经电生理检查，主要检测项目包括：正中神经、尺神经、前臂内侧皮神经的感觉神经传导和运动神经传导，以及前臂正中神经、尺神经所支配的相关肌肉肌电图。必要时进行桡神经、肌皮神经、腋神经所支配的相关肌肉肌电图检测，下肢神经传导及胸锁乳突肌、椎旁肌等相关肌肉肌电图检测。结果本组48例患者中，神经电生理检查提示为肘管综合征31例，腕尺管综合征5例，颈椎病6例，周围神经病3例，运动神经元病2例，胸廓出口综合征（下干型）1例。结论神经电生理检查可以对无明确外伤史出现第一背侧骨问肌萎缩的患者提供客观的检测指标，对其病因诊断具有重要价值。

Objective To explore the value ofneuro-electrophysiological technique in the clinical diagnosis and differential diagnosis for the patients with the first dorsal interosseous muscle atrophy. Methods From January 2015 to May 2017, neuro-electrophysiological examination was performed in 48 cases （51 sides） with first dorsal interosseous muscle atrophy but without definite trauma history. The main test items included sensory and motor nerve conduction of median nerve, ulnar nerve and forearm medial cutaneous nerve, and the related muscle electromyogram dominated by forearm median nerve and ulnar nerve. If necessary, the electromyogram of relative muscles innervated by radial nerve, musculocutaneous nerve and axillary nerve was done. Lower extremity nerve conduction and stemocleidomastoid muscle, paravertebral muscle electromyogram were also done. Results Of the 48 patients, the neuro-electrophysiological examination showed 31 cases of cubital tunnel syndrome, 5 cases of ulnar tunnel syndrome, 6 cases of cervical spondylosis, 3 cases of peripheral neuropathy, 2 case of motor neuron disease, 1 case of thoracic outlet syndrome （lower trunk type）. Conclusion Neuro-electrophysiological examination has an important etiological diagnostic value in patients with the first dorsal interosseous muscle atrophy without definite trauma history.