Electrophysiologic features of ulnar neuropathy in childhood and adolescence |
| |
Authors: | Ioannis Karakis Wendy Liew Heather Szelag Fournier H. Royden Jones Basil T. Darras Peter B. Kang |
| |
Affiliation: | 1. Department of Neurology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA;2. Department of Neurology, Lahey Clinic, Burlington, MA, USA;3. Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA;4. Department of Neurology, KK Women’s & Children’s Hospital, Singapore;5. Division of Pediatric Neurology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA;6. Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA |
| |
Abstract: | ObjectiveTo analyze patterns of nerve injury in pediatric ulnar neuropathy (PUN).MethodsRetrospective analysis of 49 children with PUN.ResultsSensory loss in digit V was the prevailing complaint (89%). Predominant localization was at the elbow (55%). Diminished ulnar SNAP was the most common abnormality (71%) with median axon loss estimate (MAXE) of 62%. Dorsal ulnar cutaneous (DUC) sensory nerve action potential (SNAP) was reduced in 55% with MAXE of 43%. Abductor digiti minimi (ADM) and first dorsal interosseous (FDI) compound muscle action potential (CMAP) were reduced half of the time, with MAXE of 30% and 28% respectively. There was high correlation between ulnar sensory MAXE and ADM MAXE (r = 0.76, p < 0.0001), FDI MAXE (r = 0.81, p < 0.0001) and DUC MAXE (r = 0.60, p = 0.0048). Neurogenic changes were seen in the ADM, FDI, flexor carpi ulnaris (FCU) and flexor digitorum profundus IV (FDP IV) in 79%, 77%, 25% and 35% respectively. Pathophysiology was demyelinating in 27%, axonal in 59% and mixed in 14%.ConclusionsIn proximal axonal lesions, sensory fibers to digit V and motor fibers to distal muscles are predominantly affected, whereas in demyelinating lesions, slowing occurs twice as frequently as conduction block.SignificanceThere is frequent axonal and fascicular injury in PUN. |
| |
Keywords: | EMG Electromyography NCS nerve conduction studies PUN pediatric ulnar neuropathy IRB institutional review board FDI first dorsal interosseus ADM abductor digiti minimi FCU flexor carpi ulnaris FDP IV flexor digitorum profundus IV CMAP compound muscle action potential DUC dorsal ulnar cutaneous SNAP sensory nerve action potential Ulnar neuropathy Ulnar nerve Electrodiagnosis Electromyography (EMG) Pediatric EMG Clinical neurophysiology |
本文献已被 ScienceDirect 等数据库收录! |
|