Ulnar neuropathy at the elbow: Reappraisal of the wrist-upper arm latency difference between ulnar and median nerves.

Details

Serval ID
serval:BIB_8D1E9E8523FD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ulnar neuropathy at the elbow: Reappraisal of the wrist-upper arm latency difference between ulnar and median nerves.
Journal
Clinical neurophysiology
Author(s)
Di Virgilio G., Grapperon A.M., Fayerstein J., Goudot M., Nollet S., Ochsner F., Théaudin M., Truffert A., Tsouni P., Vial C., Wang F.C., Pasquier J., Tatu L., Attarian S., Kuntzer T.
ISSN
1872-8952 (Electronic)
ISSN-L
1388-2457
Publication state
Published
Issued date
02/2020
Peer-reviewed
Oui
Volume
131
Number
2
Pages
372-376
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To evaluate the sensitivity and specificity of the latency difference (DLat) between ulnar and median nerves of the arm after stimulation at the wrist; one of the easiest techniques proposed for recognizing ulnar neuropathy at the elbow (UNE). As latency difference is not a standardized technique, we set up a multicenter study to recruit large numbers of normal subjects and patients with UNE or generalized neuropathy.
Six centers participated in the study with data obtained from three groups of participants, controls (CTRLs), patients with UNE and patients with generalized neuropathy (GNP). We first verified the anatomical superposition of the ulnar and median nerves in cadaver examination. The optimal recording site for these two nerves was found to be 10 cm above the medial epicondyle. We then standardized the position of the arm with full extension of the elbow and stimulated first the median and then the ulnar nerves at the wrist. CTRLs were examined on both arms at two consecutive visits.
We recorded 32 idiopathic UNE cases, 44 GNP patients and 62 controls. We demonstrated that a DLat cut-off value of 0.69 ms brings a sensitivity of 0.86 and specificity of 0.89 to discriminate CTRLs from UNE. We also validated that intra-examiner reproducibility was good.
We report a lower normal value for DLat than reported in several non-standardized studies and CTRL and UNE groups have clearly separated DLat values.
Due to its high sensitivity, our standardized technique could be used as a first-line diagnostic tool when UNE is suspected.
Keywords
Adult, Aged, Elbow/physiopathology, Electrodiagnosis/methods, Electrodiagnosis/standards, Female, Humans, Male, Median Nerve/physiopathology, Middle Aged, Neural Conduction, Reaction Time, Sensitivity and Specificity, Ulnar Nerve/physiopathology, Ulnar Neuropathies/diagnosis, Ulnar Neuropathies/physiopathology, Wrist/physiopathology, Nerve conduction study, Neurophysiology, Ulnar neuropathy
Pubmed
Web of science
Create date
03/01/2020 16:55
Last modification date
29/08/2020 6:20
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