Ginanneschi Federica, Mondelli Mauro, Cioncoloni David, Rossi Alessandro
Department of Medical, Surgical and Neurological Sciences, Neurology Neurophysiology Unit, University of Siena, Italy.
EMG Service, Local Health Unit 7, Siena, Italy.
J Electromyogr Kinesiol. 2018 Jun;40:32-38. doi: 10.1016/j.jelekin.2018.03.004. Epub 2018 Mar 20.
Considerable debate exists in the literature about possible anomalies of ulnar nerve at wrist in carpal tunnel syndrome (CTS). We systematically reviewed the literature about electrophysiologic and morphologic changes of ulnar nerve at wrist in CTS. We carried out a comprehensive search using PubMed from 1963 through October 2017. Data were extracted and the quality of the included studies was evaluated. Twenty-eight studies were selected. Seventy-nine percent of the studies report abnormalities of the ulnar nerve conduction. There was a relation between the median and ulnar nerve conduction in almost all the papers, i.e., conduction impairment of the ulnar nerve increased with increasing severity of median nerve involvement, emerging as a process correlated with damage of the median nerve. Seventy-five percent of ultrasonographic studies report changes of ulnar nerve cross sectional area in CTS. Morphologic and functional changes of the ulnar nerve and/or Guyon canal are reported by 100% of papers addressed to this topic. Several papers quoted in this review have some flaws. The key message of present review is that electrophysiological and morphological changes of the ulnar nerve at the wrist can occur in CTS, although the possibility of an overestimation of the phenomenon needs to be considered.
关于腕管综合征（CTS）中腕部尺神经可能存在的异常，文献中存在相当多的争论。我们系统回顾了有关CTS中腕部尺神经电生理和形态学变化的文献。我们使用PubMed进行了从1963年到2017年10月的全面检索。提取了数据并评估了纳入研究的质量。共选择了28项研究。79%的研究报告了尺神经传导异常。几乎所有论文中，正中神经和尺神经传导之间都存在关联，即尺神经传导障碍随着正中神经受累程度的加重而增加，这是一个与正中神经损伤相关的过程。75%的超声研究报告了CTS中尺神经横截面积的变化。100%涉及该主题的论文都报告了尺神经和/或Guyon管的形态学和功能变化。本综述引用的几篇论文存在一些缺陷。本综述的关键信息是，CTS中腕部尺神经可出现电生理和形态学变化，尽管需要考虑该现象被高估的可能性。
