Scola R H, Werneck L C, Iwamoto F M, Maegawa G H, Faoro L N, Caldeira F H
Departamento de Clínica Médica, Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Brasil.
Arq Neuropsiquiatr. 1999 Sep;57(3A):659-65. doi: 10.1590/s0004-282x1999000400020.
True neurogenic thoracic outlet syndrome is caused by compression of the lower trunk of the brachial plexus usually by a cervical rib, fibrous band or an elongated transverse process of C7. We describe two cases of female patients (23 and 19 years old) with pain in the right superior limb and progressive muscular weakness and atrophy of the intrinsic muscles of hand. Electrodiagnostic studies showed reduced amplitude of compound muscle action potential of median nerve and decreased amplitude of ulnar sensory nerve action potential. Motor and sensory nerve conduction velocities were normal in both patients. Needle electromyography were findings compatible with chronic denervation in the intrinsic muscles of the right hand of both patients. Radiological investigation showed cervical ribs in one case and elongated transverse process of C7 in the other. A discussion about the clinical and electrophysiological features and the treatment of the syndrome was performed.
真性神经源性胸廓出口综合征通常由臂丛下干受压引起,压迫因素多为颈肋、纤维带或C7横突过长。我们描述了两名女性患者(分别为23岁和19岁),她们均有右上肢疼痛以及手部固有肌进行性肌无力和萎缩的症状。电诊断研究显示,正中神经复合肌肉动作电位幅度降低,尺神经感觉神经动作电位幅度减小。两名患者的运动和感觉神经传导速度均正常。针极肌电图检查结果显示,两名患者右手固有肌均存在与慢性失神经支配相符的表现。影像学检查显示,一例患者有颈肋,另一例患者有C7横突过长。本文对该综合征的临床和电生理特征以及治疗方法进行了讨论。