Padua L, Aprile I, Caliandro P, Foschini M, Mazza S, Tonali P
Institute of Neurology, Università Cattolica, L.go F. Vito, Rome, Italy.
Clin Neurophysiol. 2002 Dec;113(12):1980-4. doi: 10.1016/s1388-2457(02)00295-x.
No clinical-neurophysiological data on natural history of ulnar neuropathy at elbow (UNE) are reported. The aim of the current study is to assess the course of untreated UNE.
We performed a follow-up at 1 year of 30 neurophysiologically positive UNE, 24 were untreated and 6 were operated on. The evaluation was based on a phone interview and sometimes on neurophysiological investigation. With regard to management of UNE, at initial evaluation we explained to the patients what UNE is and how to avoid posture that can worsen nerve compression.
Around half of the untreated patients reported improvement of symptoms at follow-up. Comparison between baseline and follow-up neurophysiological measurements showed a significant spontaneous improvement. Most patients reported changing of arm posture after UNE diagnosis.
Some UNE cases improve spontaneously without surgical treatment. A part of the improvements could be due to the changing of arm postures. We hypothesize that a good diagnosis that includes an explanation of the anatomical condition of the nerve during postures and movements represents the first therapy for the entrapments.
目前尚无关于肘部尺神经病变（UNE）自然病史的临床神经生理学数据报道。本研究旨在评估未经治疗的UNE的病程。
我们对30例神经生理学检查确诊的UNE患者进行了为期1年的随访，其中24例未接受治疗，6例接受了手术治疗。评估基于电话访谈，有时也进行神经生理学检查。关于UNE的处理，在初始评估时，我们向患者解释了什么是UNE以及如何避免可能加重神经压迫的姿势。
约一半未接受治疗的患者在随访时报告症状有所改善。基线与随访神经生理学测量结果比较显示有显著的自发改善。大多数患者报告在UNE诊断后改变了手臂姿势。
一些UNE病例未经手术治疗可自发改善。部分改善可能归因于手臂姿势的改变。我们推测，包括在姿势和运动过程中对神经解剖状况进行解释的良好诊断是对卡压性病变的首要治疗方法。
