Mansukhani K A, D'Souza C
Department of Clinical Neurophysiology, Bombay Hospital.
Indian J Med Res. 1991 Dec;94:433-6.
Unilateral ulnar neuropathy at the elbow was detected in 12 men employed as diamond assorters. Asymptomatic diamond assorters were studied as controls. In the symptomatics, the ulnar neuropathy was restricted to the hand which held the eye-glass used for inspecting the diamonds. Electrophysiological studies using several parameters revealed neurapraxia sometimes combined with axonal degeneration in the ulnar nerve at the elbow, compatible with compression at that site. The most sensitive parameters of abnormality in the symptomatic subjects were segmental slowing of motor nerve conduction velocity across the elbow (P less than 0.001) and the amplitude of the compound muscle action potential obtained on stimulating the nerve above the elbow (P less than 0.001). In the 18 asymptomatic diamond assorters, electrophysiological studies revealed an ulnar neuropathy in two (again in the hand used for holding the eye-glass). Ulnar mononeuropathy at the elbow thus seems to be an occupational hazard for diamond assorters and it is worthwhile to elicit occupational history from patients presenting with an ulnar mononeuropathy, especially in Bombay and Gujarat where diamond industry is concentrated.
在12名从事钻石分拣工作的男性中检测出肘部单侧尺神经病变。选取无症状的钻石分拣工人作为对照进行研究。在有症状的患者中，尺神经病变仅限于用于手持检查钻石用眼镜的那只手。通过多个参数进行的电生理研究显示，肘部尺神经有时存在神经失用并伴有轴突变性，符合该部位受压的表现。有症状受试者中最敏感的异常参数是肘部运动神经传导速度的节段性减慢（P<0.001）以及刺激肘部上方神经时复合肌肉动作电位的波幅（P<0.001）。在18名无症状的钻石分拣工人中，电生理研究发现有两人存在尺神经病变（同样是在用于手持眼镜的那只手）。因此，肘部尺神经单神经病似乎是钻石分拣工人的一种职业危害，对于出现尺神经单神经病的患者，尤其是在钻石产业集中的孟买和古吉拉特邦，了解其职业史是很有必要的。
