Davidoff G, Werner R, Waring W
Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor.
Paraplegia. 1991 Jan;29(1):17-24. doi: 10.1038/sc.1991.3.
Controversy exists with regard to the actual prevalence of compressive mononeuropathies at the wrist which may occur following chronic paraplegia. Thirty one chronic paraplegics, with a mean age of 37.9 years (range 20-68 years), and mean time since injury of 9.7 years (range 1-28 years), were studied with a comprehensive neurologic and electrodiagnostic (EDX) assessment. No patient had any clinical or EDX evidence of a peripheral polyneuropathy. The diagnosis of a median mononeuropathy at the wrist was determined by the following criteria: (a) prolonged median sensory distal latency greater than ipsilateral ulnar sensory distal latency greater than or equal to 0.5 msec; (b) a median mid-palmar sensory latency greater than ipsilateral ulnar mid-palmar sensory latency of greater than or equal to 0.3 msec; or (c) a median motor distal latency greater than or equal to 1.7 milliseconds as compared to the ipsilateral ulnar motor distal latency. Ulnar mononeuropathy at the wrist or across the elbow was also characterised. The EDX criteria for a median mononeuropathy at the wrist was met in 55% of subjects (24% of these with bilateral presentations). The location of ulnar mononeuropathies included: two at the superficial sensory branch at the wrist, one at the deep motor branch at the wrist, and three patients with a conduction block across the elbow. Overall, 67% of all patients tested had evidence of at least one mononeuropathy of the upper extremity. There was no association between prevalence of compressive mononeuropathies and age of the patient or time since onset of injury.
对于慢性截瘫后可能出现的腕部压迫性单神经病的实际患病率存在争议。对31例慢性截瘫患者进行了全面的神经学和电诊断（EDX）评估，这些患者的平均年龄为37.9岁（范围20 - 68岁），受伤后的平均时间为9.7年（范围1 - 28年）。没有患者有任何周围性多发性神经病的临床或EDX证据。腕部正中神经单神经病的诊断依据以下标准确定：（a）正中神经感觉远端潜伏期延长，大于同侧尺神经感觉远端潜伏期大于或等于0.5毫秒；（b）正中神经掌中部感觉潜伏期大于同侧尺神经掌中部感觉潜伏期大于或等于0.3毫秒；或（c）与同侧尺神经运动远端潜伏期相比，正中神经运动远端潜伏期大于或等于1.7毫秒。还对腕部或肘部尺神经单神经病进行了特征描述。55%的受试者符合腕部正中神经单神经病的EDX标准（其中24%为双侧表现）。尺神经单神经病的部位包括：2例位于腕部浅感觉支，1例位于腕部深运动支，3例在肘部存在传导阻滞。总体而言，所有接受测试的患者中有67%有上肢至少一种单神经病的证据。压迫性单神经病的患病率与患者年龄或受伤后时间之间没有关联。
