Rota Eugenia, Zavaroni Donatella, Parietti Letizia, Iafelice Ilaria, De Mitri Paola, Terlizzi Emilio, Morelli Nicola, Immovilli Paolo, Guidetti Donata
U.O.C. Neurologia, Ospedale G. da Saliceto, Piacenza, Italy.
U.O. Diabetologia, Ospedale G. da Saliceto, Piacenza, Italy.
Diabetes Res Clin Pract. 2014 Apr;104(1):73-8. doi: 10.1016/j.diabres.2014.01.024. Epub 2014 Feb 3.
This study aimed to assess the prevalence and electrophysiological features of ulnar entrapment neuropathy in patients with type 2 diabetes mellitus (DM).
Nerve conduction studies (NCS) were performed in a sample of consecutive diabetic patients aged 25-75 years, referred by the Diabetology Unit. NCS of the median, ulnar, radial, peroneal and sural nerves were performed on the non-dominant side. Median entrapment neuropathy at the wrist (MNW) and ulnar neuropathy at the elbow (UNE) and wrist (UNW) were diagnosed according to standard electrodiagnostic criteria.
Sixty-four patients were enrolled, 28 male (44%), average age 61, average DM duration 14.5 years. Polyneuropathy was diagnosed in 45 subjects (70%). UNE was detected in 22 patients (34%) (4 did not have polyneuropathy), in the abductor digiti minimi in 16, the first interosseus in 14 and in both in 8. UNW was detected in 7 (11%) subjects and MNW in 40 (63%). NCS alterations consistent with ulnar neuropathy were detected in a high proportion of patients (45%), suggesting that the ulnar nerve is very susceptible to focal entrapment in DM.
Upper limb sensory and motor NCS, including motor conduction velocity across the elbow, should be considered in the staging of DM patients.
本研究旨在评估2型糖尿病（DM）患者尺神经卡压性神经病的患病率及电生理特征。
对糖尿病科转诊的25至75岁连续糖尿病患者样本进行神经传导研究（NCS）。在非优势侧对正中神经、尺神经、桡神经、腓总神经和腓肠神经进行NCS。根据标准电诊断标准诊断腕部正中神经卡压性神经病（MNW）、肘部尺神经卡压性神经病（UNE）和腕部尺神经卡压性神经病（UNW）。
共纳入64例患者，男性28例（44%），平均年龄61岁，平均糖尿病病程1年。45例（70%）患者被诊断为多发性神经病。22例（34%）患者检测到UNE（4例无多发性神经病），其中小指展肌16例，第一骨间肌14例，两者均受累8例。7例（11%）患者检测到UNW，40例（63%）患者检测到MNW。高比例患者（45%）检测到与尺神经病变一致的NCS改变，提示尺神经在糖尿病中极易发生局灶性卡压。
在糖尿病患者分期时应考虑进行上肢感觉和运动NCS，包括肘部运动传导速度。
