超声检查腕部正中神经明显增大的临床与电诊断相关性。

IF 3 Q2 CLINICAL NEUROLOGY
Lisa B E Shields, Vasudeva G Iyer, Theresa Kluthe, Kahir Jawad, Jun Cai, Yi Ping Zhang, Christopher B Shields
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引用次数: 0

摘要

背景/目的:本研究回顾性分析了36例经电诊断(EDX)确诊为腕管综合征(CTS)的患者,并通过超声(US)检测到腕部明显的正中神经扩张(定义为横截面积[CSA]为40mm2或更大)。方法:我们描述了这些患者的临床、电诊断(EDX)和超声检查结果,并讨论了正中神经明显扩大的病理生理基础。结果:超声检查发现39只手(36例,双侧3例)正中神经明显增大。在39只手中,15只手(38.5%)出现鱼际萎缩,所有手的正中神经分布均出现针刺消失。EDX检查分别在21只手(53.8%)和16只手(41.0%)中证实了中度或重度腕管正中神经卡压(CT)。12只手(30.8%)未检测到拇短外展肌复合肌动作电位(cmap), 31只手(79.5%)未检测到感觉神经动作电位(snap)。20只手(51.3%)腕部CSA在40 - 44 mm2之间,13只手(33.3%)在45 - 49 mm2之间,6只手(15.4%)在50 mm2以上。结论:正中神经明显扩大对CTS手术治疗的影响尚不清楚,需要进一步的前瞻性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical and Electrodiagnostic Correlations of Ultrasound-Detected Markedly Enlarged Median Nerve at the Wrist.

Background/objectives: This is a retrospective review of 36 patients with electrodiagnostic (EDX) confirmation of carpal tunnel syndrome (CTS) and ultrasound (US) detection of marked median nerve enlargement (defined as a cross-sectional area [CSA] of 40 mm2 or greater) at the wrist.

Methods: We describe the clinical, electrodiagnostic (EDX), and US findings in these patients and discuss the pathophysiologic basis of a markedly enlarged median nerve.

Results: The markedly enlarged median nerve was detected by US in a total of 39 hands (36 patients, with 3 bilateral). Of the 39 hands, thenar atrophy was observed in 15 (38.5%) hands, and pinprick loss in the median nerve distribution was noted in all hands. Moderately severe or severe median nerve entrapment at the carpal tunnel (CT) was confirmed by EDX studies in 21 (53.8%) and 16 (41.0%) hands, respectively. A total of 12 (30.8%) hands had no compound muscle action potentials (CMAPs) over the abductor pollicis brevis muscle, and sensory nerve action potentials (SNAPs) were not detected in 31 (79.5%) hands. The wrist CSA was between 40 and 44 mm2 in 20 (51.3%) hands, between 45 and 49 mm2 in 13 (33.3%) hands, and 50 mm2 or greater in 6 (15.4%) hands.

Conclusions: The implications of the markedly enlarged median nerve for surgical management of CTS are unknown, and future prospective studies are needed.

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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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