Combined Martin-Gruber and complete Riché-Cannieu anastomoses disclosed during the electrodiagnostic evaluation of carpal tunnel syndrome

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2024-01-01 DOI:10.1016/j.cnp.2024.10.004

Kevin J. Felice

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引用次数: 0

Abstract

Background

Electromyographers are frequently confronted by anomalous innervations and some may challenge the interpretation of nerve conduction studies (NCS). Reports of 2 or more anomalous innervations in the same patient are rare. I describe the NCS in a patient referred for an evaluation of carpal tunnel syndrome (CTS) who was found to harbor a combined Martin-Gruber anastomosis (MGA) and complete Riché-Cannieu anastomosis (RCA).

Case presentation

This 31-year-old man was referred for electrodiagnostic studies following several months of intermittent right hand numbness and tingling. Clinical exam was normal. Median and ulnar motor NCS showed evidence of a combined MGA and complete RCA. Prolongation of the median sensory peak latency and median-2nd lumbrical motor distal latency provided the electrodiagnostic clues in support of CTS.

Discussion

In summary, this report describes the rare occurrence of a combined MGA and complete RCA in a patient with CTS, demonstrates how NCS can sort out this dual anomaly, and discusses the electrodiagnostic and cadaveric literature on the topic.

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在对腕管综合征进行电诊断评估时发现的马丁-格鲁伯和完全里奇-坎尼厄联合吻合术

背景肌电图医生经常会遇到神经支配异常的情况，其中一些可能会对神经传导研究（NCS）的解释提出质疑。在同一患者中出现 2 个或 2 个以上异常神经支配的报告并不多见。我描述了一名因评估腕管综合征（CTS）而转诊的患者的神经传导检查结果，该患者被发现患有马丁-格鲁伯吻合术（MGA）和完全里奇-卡尼厄吻合术（RCA）。临床检查结果正常。正中和尺骨运动 NCS 显示合并 MGA 和完全 RCA。正中感觉峰值潜伏期和正中-第 2 腰椎运动远端潜伏期的延长提供了支持 CTS 的电诊断线索。讨论综上所述，本报告描述了一名 CTS 患者合并 MGA 和完全 RCA 的罕见病例，展示了 NCS 如何分辨这种双重异常，并讨论了有关该主题的电诊断和尸体文献。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.