Kouyoumdjian João A, Graça Carla R, Ferreira Vanessa F M
Department of Neurological Sciences, Neuromuscular Investigation Laboratory, Faculdade de Medicina de São José do Rio Preto (FAMERP), São Paulo, Brazil.
Neurol India. 2017 May-Jun;65(3):551-555. doi: 10.4103/neuroindia.NI_987_16.
Peripheral nerve injuries (PNIs) remain an important health problem often leading to severe motor disabilities predominantly in the younger population.
To analyze our experience of clinical and electrodiagnostic evaluation (EDX) of PNIs over a 26-year period.
Between 1989 and 2014, 1124 consecutive patients with 1418 PNIs were referred for clinical as well as EDX evaluation. These PNIs involved upper and lower limbs as well as the facial nerves. Patients with iatrogenic lesions and spinal cord/spinal root lesions were excluded from this analysis. Brachial plexus (BP) injuries with associated or not with root avulsions were considered as one particular nerve and was include in the study as BP. The etiological categories of the sustained trauma included vehicular accidents, penetrating injuries, falls, gunshot wounds, car accidents involving pedestrians, sports injuries, and miscellaneous injuries.
The mean age of our patients was 34.2 years and most were males (76.7%). Majority (80.9%) of the PNIs were isolated injuries. Combined lesions most commonly involved the ulnar and median nerves. Upper-limb PNIs accounted for 72.6% of our patients. The ulnar nerve was injured most often, either singly or in combination. Vehicular accidents were the most common causes of injury (46.4%), affecting the brachial BP or the radial, fibular, or sciatic nerves. Penetrating trauma (23.9%) commonly affected the ulnar and the median nerves. Falls and gunshot wounds frequently affected the ulnar, radial, and median nerves. Sports injuries, mostly soccer related, affected predominantly the fibular nerves. BP injuries were considerably more common in accidents involving motorcycles than those involving cars (46.1% vs. 17.1%), and root avulsions was more frequently associated in these cases.
Most PNIs were caused by vehicular accidents and penetrating trauma, and affected young men. Overall, ulnar nerve, primary BP, and median nerve PNIs were the most prevalent lesions.
周围神经损伤（PNIs）仍然是一个重要的健康问题，主要在年轻人群中常导致严重的运动功能障碍。
分析我们在26年期间对周围神经损伤进行临床和电诊断评估（EDX）的经验。
1989年至2014年期间，1124例连续患者共发生1418例周围神经损伤，接受了临床及电诊断评估。这些周围神经损伤累及上肢、下肢及面神经。医源性损伤和脊髓/脊神经根损伤患者被排除在本分析之外。伴有或不伴有神经根撕脱的臂丛（BP）损伤被视为一条特定神经，并作为臂丛纳入研究。持续创伤的病因类别包括交通事故、穿透伤、跌倒、枪伤、涉及行人的汽车事故、运动损伤和其他损伤。
患者的平均年龄为34.2岁，大多数为男性（76.7%）。大多数（80.9%）周围神经损伤为孤立伤。合并损伤最常见累及尺神经和正中神经。上肢周围神经损伤占患者的72.6%。尺神经最常受伤，可为单独损伤或合并损伤。交通事故是最常见的损伤原因（46.4%），影响臂丛、桡神经、腓总神经或坐骨神经。穿透伤（23.9%）常累及尺神经和正中神经。跌倒和枪伤常累及尺神经、桡神经和正中神经。运动损伤大多与足球相关，主要影响腓总神经。在涉及摩托车的事故中，臂丛损伤比涉及汽车的事故更为常见（46.1%对17.1%），且在这些病例中神经根撕脱更频繁。
大多数周围神经损伤由交通事故和穿透伤引起，且影响年轻男性。总体而言，尺神经、原发性臂丛和正中神经周围神经损伤是最常见的病变。
