Grimaud J, Chapuis F, Millan J
Institut de Léprologie Appliquée de Dakar, Fondation de l'Ordre Souverain de Malte, Sénégal.
Rev Neurol (Paris). 1994 Nov;150(11):791-5.
In leprosy, ulnar neuritis is considered to be selectively localised at the elbow and is often treated by surgical decompression when pain and/or neurological deficit occurs. The aim of this prospective study is to assess the prevalence, localisation and severity of ulnar nerve damage in leprosy. Motor nerve conduction velocity (MNC) was measured at 3 different segments: arm, elbow and forearm, and was expressed both in meters/second and percentage of the mean normal values found in our laboratory or as reported in other studies. The patient group consisted of 123 consecutive new leprosy sufferers (228 ulnar nerves only) who attended the Institut de Léprologie Appliquée de Dakar over the period of one year. Diagnosis and classification were based on Ridley & Jopling's criteria, including skin and nerve biopsy. Mean MNC was reduced by 13.5 m/s at the arm, 19.8 m/s at the elbow and 7.8 m/s at the forearm as compared to the mean normal values. Increased distal latency as an isolated finding was rare (0.9%). Mean MNC was more reduced in the BL, LL (lepromatous) than in the TT, BT (tuberculoid) subgroups, despite similar disease durations (22.3 +/- 18.7 months and 24.2 +/- 26.4 months respectively (n.s.). Using different normal MNC values did not affect the conclusion: we did not see any selective slowing of ulnar MNC at the elbow suggesting that nerve damage is not primarily related to mechanical factors.
在麻风病中,尺神经炎被认为选择性地局限于肘部,当出现疼痛和/或神经功能缺损时,通常采用手术减压治疗。这项前瞻性研究的目的是评估麻风病中尺神经损伤的患病率、定位和严重程度。在三个不同节段测量运动神经传导速度(MNC):上臂、肘部和前臂,并以米/秒以及我们实验室或其他研究报告中发现的正常平均值的百分比来表示。患者组由连续123例新的麻风病患者组成(仅228条尺神经),他们在一年的时间里到了达喀尔应用麻风病研究所就诊。诊断和分类基于里德利和乔普林的标准,包括皮肤和神经活检。与正常平均值相比,上臂的平均MNC降低了13.5米/秒,肘部降低了19.8米/秒,前臂降低了7.8米/秒。单纯出现远端潜伏期延长的情况很少见(0.9%)。尽管疾病持续时间相似(分别为22.3±18.7个月和24.2±26.4个月(无显著性差异)),但在瘤型麻风(BL、LL)亚组中,平均MNC的降低比结核样型麻风(TT、BT)亚组更明显。使用不同的正常MNC值并不影响结论:我们没有看到肘部尺神经MNC有任何选择性减慢,这表明神经损伤主要与机械因素无关。