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Ulnar nerve entrapment at the elbow localized by short segment stimulation
R V Kanakamedala1, D G Simons, R W Porter
1Rehabilitation Medicine Service, VA Medical Center, Long Beach, CA 90822.
Archives of Physical Medicine and Rehabilitation
|November 1, 1988
Summary
Short segment stimulation effectively identifies ulnar nerve entrapment at the elbow. This technique precisely locates nerve compression by analyzing motor nerve conduction velocity and compound muscle action potential amplitudes.
Area of Science:
- Neurology
- Neurophysiology
- Clinical Electrophysiology
Background:
- Ulnar neuropathy at the elbow is a common condition.
- Accurate localization of nerve lesions is crucial for effective treatment.
- Traditional nerve conduction studies may lack precision in pinpointing entrapment sites.
Purpose of the Study:
- To evaluate differences in hypothenar muscle compound muscle action potential amplitudes and conduction times.
- To assess the utility of short segment stimulation of the ulnar nerve across the elbow.
- To determine the effectiveness of this technique in localizing ulnar nerve entrapment.
Main Methods:
- Stimulating the ulnar nerve at 2-cm intervals across the elbow in 20 healthy adults.
- Measuring motor nerve conduction velocity, compound muscle action potential amplitudes, and conduction times.
- Applying the short segment stimulation technique to 13 patients with suspected ulnar neuropathy at the elbow.
Main Results:
- Normal distal-to-proximal amplitude reduction was 6% (left) and 4.2% (right).
- Maximum conduction time in a 2-cm segment was 0.63 msec (right) and 0.60 msec (left).
- In patients, abnormalities in conduction time and/or amplitude were observed, aiding lesion localization.
Conclusions:
- Short segment stimulation of the ulnar nerve at the elbow is a valuable tool.
- This technique accurately localizes the exact site of nerve entrapment or compression.
- It improves diagnostic precision for ulnar neuropathy at the elbow.