Institute of Clinical Neurophysiology, Division of Neurology, University Medical Centre Ljubljana, Slovenia.
Clin Neurophysiol. 2022 Jan;133:104-110. doi: 10.1016/j.clinph.2021.10.010. Epub 2021 Nov 9.
To establish length of the affected nerve segment (LANS) in ulnar neuropathy at the elbow (UNE).
In a group of our previously reported UNE patients we identified 2-cm segments with reduced motor nerve conduction velocity (MNCV) on electrodiagnostic (EDx) studies and increased nerve cross-sectional areas (CSA) on ultrasonographic (US) studies. LANS was obtained by summation of these abnormal 2-cm segments separately for each approach. We also studied effect of selected independent parameters on LANS.
Altogether we studied 189 patients (194 arms). Mean (SD) LANS determined in 171 arms with reduced ulnar MNCV was 4.15 (1.89) cm, and was similar (p = 0. 21) to LANS obtained in 147 arms with increased CSA 4.46 (2.29) cm. Longer LANS were found in right arms, clinically severe UNE, axonal UNE and UNE due to entrapment. The most commonly affected 6 cm segment included 89% of abnormal 2-cm segments, with 50% of included 2-cm segments being normal. By contrast, the whole 10 cm segment included all abnormal 2-cm segments, with 66% of included segments being normal.
In UNE both EDx and US studies revealed average LANS of around 4 cm. LANS was longer in more severe UNE.
LANS needs to be taken into account in discussion of the mechanisms of UNE and approach to EDx diagnosis of UNE, particularly length of the segment used in nerve conduction studies across the elbow.
确定肘管尺神经病变（UNE）中受累神经节段的长度（LANS）。
在我们之前报道的一组 UNE 患者中，我们确定了在电诊断（EDx）研究中运动神经传导速度（MNCV）降低，超声检查（US）研究中神经横截面积（CSA）增加的 2cm 节段。通过分别对每种方法的这些异常 2cm 节段进行求和，获得 LANS。我们还研究了选定的独立参数对 LANS 的影响。
我们共研究了 189 例患者（194 侧）。在 171 例 MNCV 降低的尺神经中，平均（SD）LANS 为 4.15（1.89）cm，与 CSA 增加的 147 例（4.46[2.29]cm）相似（p=0.21）。右侧臂、临床严重 UNE、轴索性 UNE 和压迫性 UNE 的 LANS 较长。最常受累的 6cm 节段包括 89%的异常 2cm 节段，其中 50%的 2cm 节段正常。相比之下，整个 10cm 节段包括所有异常的 2cm 节段，其中 66%的节段正常。
在 UNE 中，EDx 和 US 研究均显示 LANS 平均约为 4cm。UNE 越严重，LANS 越长。
在讨论 UNE 的发病机制和 UNE 的 EDx 诊断方法时，需要考虑 LANS，特别是在肘部神经传导研究中使用的节段长度。
