神经电生理检查对神经根型颈椎病与肘管综合征的鉴别诊断价值

目的：探讨神经电生理检查对神经根型颈椎病与肘管综合征的鉴别诊断价值。方法：对14例以手部内在肌萎缩为主要临床表现的患者进行双上肢体感诱发电位（somatosensory evoked potential，SEP）、双侧正中神经和尺神经传导速度（nerve conduction velocity，NCV）、双侧第一背侧骨间肌和尺侧腕屈肌肌电罔（electromyogram，EMG）检查。结果：3例以尺神经肘上-肘下段传导速度减慢大于10m／s及第一背侧骨间肌神经源性损害为主，诊断为肘管综合征；4例以SEP颈髓至外周电位（N9-N13）峰间潜伏期延长和尺侧腕屈肌、第一背侧骨间肌神经源性损害为主，诊断为神经根型颈椎病；7例为尺侧腕屈肌及第一背侧骨间肌神经源性损害、尺神经肘上-肘下段传导速度减慢大于10m／s、SEPN9-N13峰间潜伏期延长，诊断为二者合并存在。手术治疗10例，术中所见均与神经电生理检查结果相符。结论：神经电生理检查在神经根型颈椎病与肘管综合征的鉴别诊断中具有重要提示意义。

Differentiatial diagnosis between cervical spondylotic radiculopathy and cubital tunnel syndrome by electrophysiology

Objective:To investigate the effectiveness of electromyography in the differential diagnosis of cervical spondylotic radiculopathy(CSR) and cubital tunnel syndrome (CTS).Method:By applying the methods of somatosensory evoked potential(SEP),nerve conduction velocity(NCV),electromyogram(EMG),14 cases who showed the same clinic symptom of hand intrinsic muscular atrophy were studied,the diagnosis,differential diagnosis,treatment,and the results were analysed.Result:Of 14 cases,3 cases were diagnosed as CTS,electromyographic examination showed the decrease of conduction velocity of ulnar nerve in above to below elbow segment over 10m/s and the neurogenic damage of first dorsal interossei.4 cases were diagnosed as CSR which showed the delay of inter-peak latency of N9-N13 SEP and the neurogenic damage of flexor carpi ulnaris and first dorsal interossei.The combination of CTS and CSR was 7 cases which showed both the neurogenic damage of flexor carpi ulnaris and first dorsal interossei and the change of NCV and SEP.The appearance during operation was the same with the results of electromyographic examination.Conclusion:Electromyographic examination shows significant effectiveness in the differentiation between CSR and CTS.