Pardal-Fernández José Manuel, Diaz-Maroto Inmaculada, Segura Tomás, de Cabo Carlos
Department of Clinical Neurophysiology, University General Hospital, C/Hnos. Falcó, 37, 02008, Albacete, Spain.
Unit of Neuromuscular Disorders, Department of Neurology, University General Hospital, Albacete, Spain.
Neurol Res Pract. 2023 Jan 26;5(1):4. doi: 10.1186/s42466-023-00230-2.
Ulnar mononeuropathy at the elbow is the second most frequent neuropathy in humans. Diagnosis is based on clinical and electrophysiological criteria and, more recently, also on ultrasound. Cross-sectional ultrasound is currently the most valued, although longitudinal ultrasound allows assessment of the entire affected trajectory of the nerve in a single view, but always in a straight line with no changes in direction, as in the extended elbow. The main aim of this work is to propose normative values for longitudinal ultrasound of the ulnar nerve at the elbow.
The neurological exploration of upper extremity, and electrophysiological and ultrasound parameters at the elbow of ulnar nerve were evaluated in 76 limbs from 38 asymptomatic subjects.
The diameters of the nerve as well as the distal and proximal areas were larger at the proximal region of the ulnar groove, and even more so in older individuals. In most of these elderly subjects, we found a small, non-significant slowdown in motor conduction velocity at the elbow with respect to the forearm (less than 5 m/s).
We observed a good correlation between the longitudinal and cross-sectional ultrasounds of the ulnar nerve at the elbow. Longitudinal ultrasound proved to be sensitive, reliable, simple and rapid, but its greatest contribution was allowing the visualization of the entire nerve trajectory in an integrated way, providing an image with good definition of the outline, proportions and intraneural characteristics of the nerve.
肘部尺神经单神经病是人类第二常见的神经病。诊断基于临床和电生理标准，最近也基于超声。目前，横断面超声最受重视，尽管纵向超声可以在单一视野中评估神经的整个受累轨迹，但总是在直线上且方向不变，就像伸直的肘部那样。这项工作的主要目的是提出肘部尺神经纵向超声的规范值。
对38名无症状受试者的76条上肢进行神经学检查，并评估肘部尺神经的电生理和超声参数。
在尺神经沟近端区域，神经直径以及远端和近端区域更大，在老年人中更是如此。在大多数这些老年受试者中，我们发现肘部相对于前臂的运动传导速度有轻微的、无统计学意义的减慢（小于5米/秒）。
我们观察到肘部尺神经纵向和横断面超声之间有良好的相关性。纵向超声被证明是敏感、可靠、简单且快速的，但其最大贡献是能够以综合方式可视化整个神经轨迹，提供一幅能清晰显示神经轮廓、比例和神经内特征的图像。
