肘部尺神经病变的临床发现和电诊断测试，以及根据部位和神经损伤类型的不同而有所差异。,American Journal of Physical Medicine & Rehabilitation

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肘部尺神经病变的临床发现和电诊断测试，以及根据部位和神经损伤类型的不同而有所差异。
American Journal of Physical Medicine & Rehabilitation ( IF 2.2 ) Pub Date : 2019-08-02 , DOI: 10.1097/phm.0000000000001286
Claudia Vinciguerra ₁ , Stefania Curti , Alessandro Aretini , Francesco Sicurelli , Giuseppe Greco , Stefano Mattioli , Mauro Mondelli

Affiliation

目的通过前瞻性评估肘部尺神经病（UNE）的临床和电诊断测试（EDX），以及根据部位（肱骨拱廊，HUA与后上groove沟，REG）和损伤生理病理学（轴突与脱髓鞘）的差异多中心病例对照研究。设计按年龄和性别匹配病例和对照。对症状进行UNE诊断。使用Mann-Whitney，卡方检验和ANOVA检验进行统计分析。结果共纳入144例和144例对照。与临床发现相比，无名指（U5）的感觉丧失具有最高的敏感性（70.8％）。跨肘运动传导速度（MCV-AE）在定位来自两个手部肌肉中的至少一个（第一骨间FDI和外展指位minimi-ADM）中的UNE记录时达到了最高灵敏度（84.7％）。来自U5的异常感觉动作电位振幅在轴突中比在脱髓鞘形式中更频繁地发生。REG和HUA之间的差异被认为是传导阻滞（CB）和工作类型。结论临床发现在UNE诊断中比EDX有用。通过ADM和FDI记录的MCV-AE可提高诊断准确性。轴突形式的临床和EDX严重性高于脱髓鞘形式，后者在REG中更为常见。在HUA中，体力劳动者盛行。这些发现可能有助于预后和治疗方法。通过ADM和FDI记录的MCV-AE可提高诊断准确性。轴突形式的临床和EDX严重性高于脱髓鞘形式，后者在REG中更为常见。在HUA中，体力劳动者盛行。这些发现可能有助于预后和治疗方法。通过ADM和FDI记录的MCV-AE可提高诊断准确性。轴突形式的临床和EDX严重性高于脱髓鞘形式，后者在REG中更为常见。在HUA中，体力劳动者盛行。这些发现可能有助于预后和治疗方法。

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Clinical Findings and Electrodiagnostic Testing in Ulnar Neuropathy at the Elbow and Differences According to Site and Type of Nerve Damage.

OBJECTIVE To evaluate the clinical and electrodiagnostic testing (EDX) in ulnar neuropathy at the elbow (UNE) and differences according to site (humeroulnar arcade, HUA, vs. retroepicondylar groove, REG) and injury physiopathology (axonal vs. demyelinating), through prospective multicenter case-control study. DESIGN Cases and controls were matched by age and sex. UNE diagnosis was made on symptoms. Statistical analysis was performed using Mann-Whitney, Chi-square and ANOVA tests. RESULTS 144 cases and 144 controls were enrolled. Sensory loss in the fifth finger (U5) had the highest sensitivity (70.8%) compared to clinical findings. Motor conduction velocity across-elbow (MCV-AE) reached the highest sensitivity (84.7%) in localizing UNE recording from at least one of two hand muscles (first interosseous-FDI and abductor digit minimi-ADM). Abnormal sensory action potential amplitude from U5 occurred more frequently in axonal than in demyelinating forms. Differences between REG and HUA regarded conduction block (CB) and job type. CONCLUSIONS Clinical findings have less usefulness than EDX in UNE diagnosis. MCV-AE recorded from both ADM and FDI increases diagnostic accuracy. Axonal forms have greater clinical and EDX severity than demyelinating forms, that are more frequent in REG. Manual workers prevailed in HUA. These findings may be helpful in prognostic and therapeutic approaches.

更新日期：2019-11-01

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