Ghaly Beshoy, Ghaly Sandy
a Freedom Physical Therapy , New York , New York.
b Department of Radiology Assiut University , Assiut , Egypt.
Neurodiagn J. 2019;59(1):23-33. doi: 10.1080/21646821.2018.1553873. Epub 2019 Jan 2.
The Neuromuscular ultrasound and Nerve conduction studies/Electromyography (NCS/EMG) are valuable diagnostic tools that examine and diagnose several nerve problems. The purpose of this case report is to describe a diagnostic electrophysiologic evaluation that differentiates between carpal tunnel syndrome (CTS) and radiculopathy in very mild or early stage cases.
The patient was a 30-year-old woman who sustained a tingling sensation in the second and third digits of her left hand, radiating pain in her left upper extremity and occasional neck pain. The patient cannot determine whether her radiating pain starts from the neck to her hand or starts from her hand up to the neck. Physical examination was not conclusive. Neuromuscular ultrasound and NCS/EMG were used to assess the median nerve at the carpal tunnel and the C6-7 nerve roots. A proof of the median nerve injury at the wrist was confirmed. The patient was treated with a night wrist splint.
The patient's symptoms were diminished after the use of the night splint for a period of approximately 4 weeks. A follow-up electrodiagnostic evaluation reveals improvement compared to the previous data with no electrophysiologic evidence of a current nerve injury status.
Neuromuscular ultrasound and NCS/EMG combined techniques helped in the differential diagnosis between CTS and C6-7 nerve roots radiculopathy. In this case, physical examination could not give an immediate conclusive answer.
神经肌肉超声和神经传导研究/肌电图（NCS/EMG）是用于检查和诊断多种神经问题的重要诊断工具。本病例报告的目的是描述一种诊断性电生理评估方法，用于区分非常轻微或早期的腕管综合征（CTS）和神经根病。
患者为一名30岁女性，左手第二和第三指有刺痛感，左上肢放射性疼痛，偶尔伴有颈部疼痛。患者无法确定其放射性疼痛是从颈部到手部，还是从手部到颈部。体格检查无明确结论。使用神经肌肉超声和NCS/EMG评估腕管处的正中神经和C6 - 7神经根。证实了腕部正中神经损伤。患者接受了夜间腕部夹板治疗。
使用夜间夹板约4周后，患者症状减轻。与之前的数据相比，随访电诊断评估显示有所改善，目前没有电生理证据表明存在神经损伤状态。
神经肌肉超声和NCS/EMG联合技术有助于区分CTS和C6 - 7神经根性神经病。在本病例中，体格检查未能立即给出明确答案。
