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Across-elbow ulnar nerve sensory conduction technique.

G Felsenthal1, M J Freed, R Kalafut

  • 1Department of Rehabilitation Medicine, Sinai Hospital, Baltimore, MD 21215.

Archives of Physical Medicine and Rehabilitation
|September 1, 1989
PubMed
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This study introduces a new sensory nerve conduction technique for evaluating ulnar nerve compression at the elbow. It provides normal values and demonstrates its clinical utility, especially for sensory-dominant symptoms.

Area of Science:

  • Neurology
  • Neurophysiology
  • Orthopedics

Background:

  • Ulnar nerve compression at the elbow is a common entrapment neuropathy.
  • Current electrodiagnostic evaluations primarily focus on motor nerve conduction.
  • Normal sensory conduction values and the clinical utility of sensory techniques for this segment are not well-established.

Purpose of the Study:

  • To report a novel sensory nerve conduction technique for the across-elbow segment of the ulnar nerve.
  • To establish normal electrodiagnostic values for this sensory technique.
  • To assess the clinical usefulness of the sensory technique in diagnosing ulnar nerve compression.

Main Methods:

  • A specific sensory nerve conduction technique was developed and applied to the across-elbow segment of the ulnar nerve.

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  • Normal values for sensory latency (onset and peak) and amplitude decrement were determined with the elbow flexed at 90 degrees over a 10-cm segment.
  • Comparable motor conduction values were also recorded.
  • Three clinical cases of ulnar nerve compression were analyzed using this technique.

    • Main Results:

    • Normal sensory latency to onset was 1.8 msec (mean +2SD) and to peak was 1.9 msec (mean +2SD).
    • Comparable motor latency was 2.0 msec.
    • Mean +2SD sensory amplitude decrement across the elbow was 41%, versus 7.6% for motor amplitude decrement.
    • The technique proved useful in diagnosing cases with predominantly sensory symptoms.

    Conclusions:

    • The developed sensory nerve conduction technique provides reliable normal values for the across-elbow ulnar nerve segment.
    • This technique is a valuable addition to electrodiagnostic assessments, particularly for identifying sensory abnormalities in ulnar nerve entrapment at the elbow.