Short segment sensory nerve stimulation in suspected ulnar neuropathy at the elbow: A pilot study

Muscle Nerve. 2019 Jan;59(1):125-129. doi: 10.1002/mus.26326. Epub 2018 Dec 18.

Abstract

Introduction: Routine ulnar nerve conduction studies may be normal in very mild ulnar neuropathies at the elbow (UNE). Short segment ulnar sensory stimulation across the elbow may detect mild abnormalities in these cases.

Methods: Short segment ulnar sensory nerve stimulation was performed in 20 controls and 15 patients with clinically suspected mild UNE. Greatest peak latency shift and amplitude drop between 2 adjacent stimulation sites were calculated.

Results: The upper limit of normal for peak latency shift and amplitude reduction between sites was 0.7 ms and 15%, respectively. Abnormal latency shift was detected in 12 of 15 patients and focal sensory conduction block in 6 of 15 patients. In 5 of 7 patients in whom all other studies were normal, sensory inching was abnormal.

Discussion: Ulnar sensory short segment stimulation may provide diagnostic confirmation and localization of the site of nerve compression in mild UNE, and may improve UNE detection when all other studies are normal. Muscle Nerve 59:125-129, 2019.

Keywords: conduction block; elbow; inching; sensory conduction studies; short segment stimulation; ulnar neuropathy.

MeSH terms

  • Adult
  • Elbow / innervation
  • Electric Stimulation*
  • Electromyography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction / physiology
  • Pilot Projects
  • Reaction Time
  • Ulnar Nerve / physiology*
  • Ulnar Neuropathies / diagnosis*
  • Ulnar Neuropathies / physiopathology*
  • Wrist / innervation