Nerve conduction study in cervical spinal cord injury: significance for hand function
1Swiss Paraplegic Centre, University Hospital Balgrist, Forchstrasse 340, CH-8008 Zürich, Switzerland.
Neurorehabilitation
|February 15, 2014
Summary
Nerve conduction studies in cervical spinal cord injury (SCI) patients can predict hand function recovery. This method helps differentiate nerve damage and guides early occupational therapy for tetraplegia.
Area of Science:
- Neuroscience
- Clinical Neurology
- Rehabilitation Medicine
Background:
- Cervical spinal cord injury (SCI) frequently results in tetraplegia, impacting hand function.
- Accurate assessment of nerve damage is crucial for predicting functional recovery in SCI patients.
Purpose of the Study:
- To evaluate the utility of median and ulnar nerve conduction studies in assessing hand function in acute and chronic tetraplegia.
- To determine if nerve conduction studies can differentiate between peripheral and central nervous system lesions causing hand paresis.
- To establish the prognostic value of nerve conduction studies for hand function recovery and occupational therapy selection in cervical SCI.
Main Methods:
- Performed hand function examination and nerve conduction studies of median and ulnar nerves.
- Included 15 patients with acute and 26 with chronic tetraplegia due to cervical SCI.
- Analyzed axonal lesions of motor and sensory nerve fibers and correlated findings with SCI level and hand function.
Main Results:
- Thirty percent of patients had mild and 20% severe axonal lesions in motor nerve fibers.
- Normal sensory nerve fiber examination suggested intramedullary damage of ventral horn cells/anterior nerve roots.
- Nerve conduction studies differentiated between peripheral (ventral horn cells/anterior nerve roots) and central (pyramidal tract) lesions.
- Motor nerve lesions were most frequent and severe in lower cervical SCI (C6-T1).
- Motor nerve conduction study results correlated with the development of active hand function, enabling grasping movements.
Conclusions:
- Median and ulnar nerve conduction studies are valuable for assessing nerve damage severity and type in tetraplegia.
- This technique offers prognostic value for hand function recovery after cervical SCI.
- Early nerve conduction study results can guide the selection of appropriate occupational therapy interventions for tetraplegic patients.
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