Electrodiagnostic Evidence of Berrettini Anastomosis

J Clin Neurophysiol. 2018 Mar;35(2):133-137. doi: 10.1097/WNP.0000000000000427.

Abstract

Purpose: Cadaveric palmar dissections reveal an ulnar sensory crossover (Berrettini anastomosis) to the third common palmar nerve so frequently that this crossover is considered a normal part of the anatomy. No literature has documented electrophysiologic evidence of the Berrettini anastomosis (BA). Presentation of third digit ulnar sensory crossover waveforms.

Methods: Retrospective chart review case series. Clinical office. Nerve conduction waveforms and data.

Results: Ulnar stimulation sensory crossover waveforms to digit three consistent with BA are presented.

Conclusions: Third digit BA is measurable in routine electrodiagnostic nerve conduction study in some patients. The observed BA latency is the same and the amplitude is smaller (25% to 33%) than the ulnar sensory response. The clinical significance of the BA sensory response is unclear. The presence of a BA in severe carpal tunnel syndrome may give a small amplitude normal latency sensory response that could be misinterpreted and lead to a false negative result.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Carpal Tunnel Syndrome / diagnosis*
  • Electric Stimulation
  • Electrodiagnosis / methods*
  • Female
  • Hand / innervation*
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction / physiology*
  • Reaction Time / physiology
  • Retrospective Studies
  • Ulnar Neuropathies / diagnosis*