Ulnar neuropathy with abnormal non-localizing electrophysiology: Clinical, electrophysiological and ultrasound findings

Autor: Dominic Ming Yin Tse, Michael R. Boland, Luciana Pelosi, Eoin Mulroy, Andrew M. Chancellor
Rok vydání: 2018
Předmět:
Zdroj: Clinical Neurophysiology. 129:2155-2161
ISSN: 1388-2457
DOI: 10.1016/j.clinph.2018.07.020
Popis: Objective To systematically study demographic, clinical, electrophysiological and nerve ultrasound characteristics of ulnar neuropathy with abnormal non-localizing electrophysiology (NL-UN) and further define the utility of ultrasound over and above the conventional electro-diagnostic approach. Method NL-UNs were prospectively identified from 113 consecutive referrals with suspected ulnar neuropathy. All received electro-diagnostic tests and ulnar nerve ultrasound. NL-UN severity was graded using clinical and electrophysiological scales. Results In 64 of 113 referrals, an ulnar mono- neuropathy was confirmed by electrophysiology. Sixteen of these 64 (25%) had NL-UN, predominantly males (14 out of 16 patients) with severe or moderate clinical and electrophysiological ratings. Ultrasound showed focal ulnar neuropathy at the elbow in 13 out of 16, and diffuse ulnar nerve abnormality in three, and identified a likely or possible causative mechanism in 11. Conclusion A significant proportion (a quarter) of ulnar neuropathies with abnormal electrophysiology were NL-UN, of heterogeneous etiology; the majority were males with significant disability and axonal loss. Ultrasound had a significant role in localization and classification that facilitated management. Significance To our knowledge, this is the first systematic prospective study that analyzes the demographic, clinical, electrophysiological and ultrasound characteristics of NL-UN in a routine clinical neurophysiology setting.
Databáze: OpenAIRE