Department of Neurology, Teikyo University School of Medicine, Tokyo, Japan.
Clin Neurophysiol. 2012 May;123(5):973-8. doi: 10.1016/j.clinph.2011.08.031. Epub 2011 Oct 15.
To document the incidence and effects of a previously unreported pitfall during routine antidromic sensory nerve conduction study (SCS) of the ulnar nerve: the spread of the wrist stimulation to the dorsal ulnar cutaneous (DUC) branch.
The subjects consisted of 20 healthy volunteers. An antidromic sensory nerve action potential (SNAP) was recorded over the proximal interphalangeal joint of the little finger, and the DUC response was monitored over the dorsum of hand to check for the occurrence of this spread.
The spread occurred in all subjects, which caused a 4-87% increase in the SNAP amplitude. The likelihood that this spread may occur during routine SCS varied among the subjects, and also within an individual subject depending on minute shifts of the stimulating site. Selective stimulation of the ulnar main trunk up to maximal intensity without spread to the DUC was not achieved despite every effort in two subjects.
This spread phenomenon may occur frequently during routine antidromic SCS, but would not be recognized without monitoring the DUC response.
This pitfall may interfere with the reproducibility of the SNAP amplitude, and also with the diagnosis of ulnar neuropathy at the wrist.
记录在常规逆行感觉神经传导研究（SCS）中尺神经时一个以前未报告的陷阱的发生率和影响：腕部刺激向尺神经背侧皮支（DUC）分支的扩散。
受试者由 20 名健康志愿者组成。在小指的近节指间关节记录逆行感觉神经动作电位（SNAP），并在手背监测 DUC 反应，以检查这种扩散的发生。
这种扩散发生在所有受试者中，导致 SNAP 幅度增加 4-87%。这种扩散在常规 SCS 中发生的可能性在受试者之间以及个体受试者中也有所不同，这取决于刺激部位的微小变化。尽管在两名受试者中都进行了最大努力，但仍未能实现选择性刺激尺神经主干而不向 DUC 扩散。
这种扩散现象在常规逆行 SCS 中可能经常发生，但如果不监测 DUC 反应，可能不会被识别。
这个陷阱可能会干扰 SNAP 幅度的可重复性，也可能会干扰腕部尺神经病变的诊断。
Zotero 插件