The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

Kurver, Anne; Smolders, Joost; Verhagen, W. I. M.; Meulstee, J.; Nijhuis, Frans

doi:10.3389/fneur.2019.00196

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…Like some previous reports [10,36] needle EMG revealed with abnormal findings in ADM (traumatic-83.33% and non-traumatic-65.51%) and FDI (70.83% in traumatic and 68.96% in non-traumatic) followed by FCU but least with the FDP.…”

Section: Sites Of Ulnar Nerve Lesions Traumatic Injuries (N=75)supporting

confidence: 77%

A retrospective study of electrodiagnostically evaluated ulnar neuropathies with special guidelines for ulnar neuropathies at elbow

Yadav

2022

Beni-Suef Univ J Basic Appl Sci

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Background The diagnosis of type, severity of ulnar neuropathy based on symptoms and clinical tests are unsatisfactory. This study aimed to retrospectively analyze ulnar neuropathies at different sites evaluated through electrodiagnostic studies (EDx), especially for ulnar neuropathy at elbow (UNE). Results Total 270 ulnar neuropathy patients’ data were recruited from laboratory record over a five-year period (2016–2021).Their demographic data, clinical history and EDx parameters were analyzed focusing on etiology, nerve lesion types, 5th-digit sensory, dorsal ulnar cutaneous nerve (DUCN) conduction, motor nerve conduction velocity (NCV) across elbow along with EMG of ADM, FDI, FCU, FDP muscles. The patients grouped into traumatic injuries—27.8% (T) and 72.2% non-traumatic (NT) had varied sensory-motor symptoms: pain—10%, altered sensation—28.1%, pain-paresthesia—14.8%, atrophy—25.2% and clawing—8.9%. UNE was the most prevalent (82.75%-NT, 66.67% -T) with < 50 m/s motor and sensory NCV across elbow. Compound muscle action potential (CMAP) amplitude > 50% drop across elbow was seen in 55.17%-NT and 54.16%-T groups. Abnormal DUCN and short-segment inching NCV were less frequently noted. In EMG, ADM (T-83.33% and NT-65.51%) and FDI (T-70.83% and NT-68.96%) muscles were evaluated the most and FDP the least. Conclusion UNE was the most common followed by forearm and wrist. NCV and CMAP across elbow are stronger EDx parameters for UNE. Neuropathy was irrespective of gender and prevalent at early of middle age. The EDx could be considered as one of the most valuable tests in confirming the localization, severity and type of ulnar nerve lesion, which favors management and prognosis of patient.

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Section: Sites Of Ulnar Nerve Lesions Traumatic Injuries (N=75)supporting

confidence: 77%

A retrospective study of electrodiagnostically evaluated ulnar neuropathies with special guidelines for ulnar neuropathies at elbow

Yadav

2022

Beni-Suef Univ J Basic Appl Sci

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“…Regardless of the inciting stimulus, appropriate exclusion diagnosis via diagnostic nerve blocks, electromyography/nerve conduction studies (EMG/NCS) are recommended, and multimodal analgesia can be used to alleviate patient discomfort. Human literature suggests that EMG, as a part of the standard confirmation of the clinical diagnosis of ulnar neuropathy, has limited added value if NCS are normal but may detect concomitant and/or additional differential diagnoses 12 . In this instance, ulnar neuropathy was satisfactorily diagnosed by ulnar nerve blockade and successfully treated with multimodal analgesia incorporating ketamine, gabapentin, meloxicam and paracetamol.…”

Section: Discussionmentioning

confidence: 96%

Ulnar neuropathy: A postoperative complication following placement of a humeral transcondylar screw in a dog

Condon¹,

Keeley²,

Beaumont³

2021

Vet Record Case Reports

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A 4‐year‐old neutered male English springer spaniel was examined because of postoperative allodynia and non‐weight bearing right thoracic limb lameness following bilateral humeral transcondylar screw placement to manage humeral intracondylar fissure. Clinical examination demonstrated signs attributable to ulnar neuropathy. Ulnar nerve block resulted in temporary resolution of clinical signs and confirmed the diagnosis. Multi‐modal analgesia resulted in the resolution of clinical signs with all medication withdrawn by 3 months postoperatively. No recurrence was reported at a 6‐month follow‐up. To our knowledge, this is the first documented report of ulnar neuropathy following humeral transcondylar screw placement in a dog.

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“…EMG of ulnar-innervated muscles does not improve the diagnostic sensitivity of EDx when NCS are normal. 80 Furthermore, EDx is unable to localize the site of ulnar nerve pathology in up to 25% of presentations. 81 Ultrasound shows focally increased CSA at the elbow, more often maximal at the retro-epicondylar groove and less often at the entrance to the cubital tunnel.…”

Section: Ulnar Neuropathy At the Elbowmentioning

confidence: 99%

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Hannaford,

Paling,

Silsby

et al. 2024

Muscle and Nerve

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Electrodiagnostic studies (EDx) are frequently performed in the diagnostic evaluation of peripheral nerve disorders. There is increasing interest in the use of newer, alternative diagnostic modalities, in particular imaging, either to complement or replace established EDx protocols. However, the evidence to support this approach has not been expansively reviewed. In this paper, diagnostic performance data from studies of EDx and other diagnostic modalities in common peripheral nerve disorders have been analyzed and described, with a focus on radiculopathy, plexopathy, compressive neuropathies, and the important neuropathy subtypes of Guillain‐Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), vasculitic neuropathy and diabetic neuropathy. Overall EDx retains its place as a primary diagnostic modality in the evaluated peripheral nerve disorders. Magnetic resonance imaging and ultrasound have developed important complementary diagnostic roles in compressive and traumatic neuropathies and atypical CIDP, but their value is more limited in other neuropathy subtypes. Identification of hourglass constriction in nerves of patients with neuralgic amyotrophy may have therapeutic implications. Investigation of radiculopathy is confounded by poor correlation between clinical features and imaging findings and the lack of a diagnostic gold standard. There is a need to enhance the literature on the utility of these newer diagnostic modalities.

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The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

Cited by 6 publications

References 15 publications

A retrospective study of electrodiagnostically evaluated ulnar neuropathies with special guidelines for ulnar neuropathies at elbow

A retrospective study of electrodiagnostically evaluated ulnar neuropathies with special guidelines for ulnar neuropathies at elbow

Ulnar neuropathy: A postoperative complication following placement of a humeral transcondylar screw in a dog

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

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