Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands.
Eur J Neurol. 2012 Dec;19(12):1582-4. doi: 10.1111/j.1468-1331.2012.03676.x. Epub 2012 Feb 16.
Unlike carpal tunnel syndrome, little is known about injection with corticosteroids in patients with an ulnar neuropathy at the elbow (UNE). The purpose of this feasibility study is to see whether injection with corticosteroids is safe in patients with UNE and whether there are grounds to launch a prospective placebo-controlled study on the effects of corticosteroids.
Patients with clinical symptoms of UNE and a nerve conduction study compatible with UNE or thickened ulnar nerve at the elbow (> 10 mm(2)) by ultrasonography were included. All included patients received an ultrasound-guided injection of 1 ml containing 40 mg methylprednisoloneacetate and 10 mg lidocainhydrochloride (Depo-Medrol(®)). Complications of the injection were monitored. After 3 months, nerve conduction studies and ultrasonography were repeated and a clinical outcome determined.
Eight patients with nine UNE were included. None of the patients mentioned increase in the symptoms directly after the injection nor had an infection on the injection site or haematoma. After 3 months, there was improvement of the symptoms in five patients. One patient deteriorated and three had no change of the symptoms at all. Overall, there was no significant change of the thickness of the ulnar nerve with mean difference -0.056 mm(2) (95% CI -2.56 to 2.45 mm(2)).
We showed that injection with corticosteroids in patients with UNE is easy and safe, and based on this result, we found enough arguments to launch a prospective, placebo-controlled trial to explore the effectiveness of corticosteroids in patients with UNE.
与腕管综合征不同，对于肘管尺神经病变（UNE）患者注射皮质类固醇的了解甚少。本可行性研究的目的是观察在UNE 患者中注射皮质类固醇是否安全，以及是否有理由开展前瞻性安慰剂对照研究皮质类固醇的疗效。
纳入具有UNE 临床症状和神经传导研究符合UNE 或超声检查肘部尺神经增厚（> 10 mm²）的患者。所有纳入的患者均接受 1 ml 包含 40 mg 醋酸甲泼尼龙和 10 mg 盐酸利多卡因（得宝松®）的超声引导注射。监测注射的并发症。3 个月后，重复进行神经传导研究和超声检查，并确定临床结果。
纳入 8 例 9 例UNE 患者。没有患者直接在注射后出现症状加重，也没有出现注射部位感染或血肿。3 个月后，5 例患者症状改善。1 例恶化，3 例症状无任何变化。总体而言，尺神经厚度无明显变化，平均差值为-0.056 mm²（95%CI-2.56 至 2.45 mm²）。
我们表明，在UNE 患者中注射皮质类固醇既简单又安全，基于这一结果，我们找到了足够的理由开展前瞻性、安慰剂对照试验，以探讨皮质类固醇在UNE 患者中的疗效。
