Hackensack Meridian Health-JFK Medical Center , Edison, New Jersey.
Neurodiagn J. 2020 Sep;60(3):185-194. doi: 10.1080/21646821.2020.1804286.
Anomalous innervations are commonly encountered on electrodiagnostic testing and may be mistaken for a pathological process, especially if seen in multiple nerves. While crossover of median-to-ulnar fibers in the forearm (Martin-Gruber anastomosis) has been frequently described, the corresponding ulnar-to-median crossover (Marinacci anastomosis) is much less commonly seen. There have been no reported cases of both of these anomalous innervations occurring together. We describe a novel case of bilateral Martin-Gruber and Marinacci anastomoses in the same patient. The importance of the case lies in the fact that the multiple pseudo-conduction blocks that result from these crossovers could potentially be misinterpreted as being pathological in nature, illustrating the need for electromyographers to be familiar with common anomalous innervations in the upper extremity and with techniques to identify them.
异常神经支配在电诊断测试中很常见，可能会被误诊为病理过程，尤其是在多个神经中出现时。虽然前臂正中神经到尺神经纤维的交叉（Martin-Gruber 吻合）经常被描述，但相应的尺神经到正中神经的交叉（Marinacci 吻合）则很少见。目前还没有同时出现这两种异常神经支配的报道病例。我们描述了一例同一患者双侧 Martin-Gruber 和 Marinacci 吻合的新病例。该病例的重要性在于，这些交叉产生的多个假性传导阻滞可能会被错误地解释为病理性的，这说明了肌电图医师需要熟悉上肢常见的异常神经支配，并掌握识别这些异常神经支配的技术。
