Dhillon Manjit S, Chu Mary Lynn, Posner Martin A
Hand and Neurology Services, New York University-Hospital for Joint Diseases Department of Orthopaedic Surgery, New York, NY, USA.
J Hand Surg Am. 2003 Jan;28(1):48-51. doi: 10.1053/jhsu.2003.50015.
Ulnar nerve-innervated intrinsic muscle weakness, in the absence of sensory complaints or deficits, usually is the result of compression at the ulnar nerve in zone II of Guyon's canal. In rare instances the problem is not caused by a compressive neuropathy but by a demyelinating focal motor neuropathy. Demyelinating neuropathies have been well documented in the neurologic literature but they have received little attention in the hand surgery literature. We report on one such case and the importance of differentiating the 2 neuropathies. Although surgery often is necessary for a compressive neuropathy it is contraindicated for a demyelinating neuropathy.
在没有感觉主诉或功能障碍的情况下,尺神经支配的手部内在肌无力通常是由于尺神经在Guyon管II区受压所致。在极少数情况下,问题并非由压迫性神经病变引起,而是由脱髓鞘性局灶性运动神经病所致。脱髓鞘性神经病在神经学文献中有充分记载,但在手外科文献中却很少受到关注。我们报告了这样一例病例,并阐述了区分这两种神经病的重要性。虽然对于压迫性神经病变通常需要进行手术,但脱髓鞘性神经病变则禁忌手术。