Diagnosis of Pure Ulnar Sensory Neuropathy Around the Hypothenar Area Using Orthodromic Inching Sensory Nerve Conduction Study: A Case Report

Abstract

Ulnar neuropathy at the wrist is an uncommon disease and pure ulnar sensory neuropathy at the wrist is even rarer. It is difficult to diagnose pure ulnar sensory neuropathy at the wrist by conventional methods. We report a case of pure ulnar sensory neuropathy at the hypothenar area. The lesion was localized between 3 cm and 5 cm distal to pisiform using orthodromic inching test of ulnar sensory nerve to stimulate at three points around the hypothenar area. Ultrasonographic examination confirmed compression of superficial sensory branch of the ulnar nerve. Further, surgical exploration reconfirmed compression of the ulnar nerve. This case report demonstrates the utility of orthodromic ulnar sensory inching test.

Neurological improvement following revision of vascular graft remnants in the upper extremity

“…Combined EMG and ultrasound have been shown to help localize the injury to the level of the brachial plexus cords, branches, or peripheral nerve. 11 , 12 , 13 , 14 In case 1, MRI of the brachial plexus showed abnormalities at the level of the infraclavicular brachial plexus. However, because MRI of the brachial plexus is not routinely obtained after vascular procedures, it is unclear if findings represent scar or expected postoperative changes vs pathological compression.…”

Localization of Ulnar Neuropathy at the Wrist Using Motor and Sensory Ulnar Nerve Segmental Studies

“…Third, cases involving only superficial sensory fibers were not observed in this study, while they have been reported previously. 18 In order to demonstrate patterns involving motor or sensory fibers depending on location and etiology, further studies that include more patients with UNW are required. Fourth, the supramaximal stimulation intensities differed among individuals due to variations in the distance from the surface to the nerve.…”