Nakazumi Y, Hamasaki M
Kanzaki Municipal Hospital, Hyogo, Japan.
Electromyogr Clin Neurophysiol. 2001 Sep;41(6):345-8.
We performed electrophysiological studies and objective physical examinations in 60 patients with carpal tunnel syndrome and 21 patients with cubital tunnel syndrome. Compared with our normal data, the sensory nerve conduction velocity across the wrist was defined as abnormal in 97% of the carpal tunnel syndrome patients, the corresponding value of the amplitude of the sensory nerve action potential was 58% and the value of the two point discrimination test was 28% while the value of the Semmes-Weinstein monofilament test was defined as abnormal in 64% of the cases. In cubital tunnel syndrome patients, motor nerve conduction velocity across the elbow was defined as abnormal in 91%, the amplitude of the M-wave was 96%, manual muscle testing was 63% and their side pinch strength was defined as abnormal in 24% of the cases. The functions of recognition are preserved in the cases with moderate damage of peripheral nerve due to the cancellation of synaptic occlusion. Motor performance also compensated in the central nervous system. Therefore the sensitivity of the objective physical examination is less than that of electrophysiological study of peripheral nerve itself. For entrapment neuropathy electrophysiological findings are more sensitive than the objective physical examinations.
我们对60例腕管综合征患者和21例肘管综合征患者进行了电生理研究和客观体格检查。与我们的正常数据相比,97%的腕管综合征患者腕部感觉神经传导速度被定义为异常,感觉神经动作电位幅度的相应值为58%,两点辨别试验的值为28%,而Semmes-Weinstein单丝试验的值在64%的病例中被定义为异常。在肘管综合征患者中,91%的患者肘部运动神经传导速度被定义为异常,M波幅度为96%,徒手肌力测试为63%,24%的病例其侧捏力被定义为异常。由于突触闭塞的消除,在周围神经中度损伤的病例中识别功能得以保留。运动表现也在中枢神经系统中得到了代偿。因此,客观体格检查的敏感性低于周围神经自身的电生理研究。对于卡压性神经病,电生理结果比客观体格检查更敏感。