Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 66

Abstract

To better assess historical, physical and neurophysiological features of UNE, 20 centers widely distributed in the national country have joined a collaborative study in November 2001. Case recognition was based on clinical ground: symptoms or signs suggestive of ulnar nerve impairment at elbow, as numbness/ paresthesia in the part of ulnar innervated hand with or without sensory loss, elbow pain and weakness of ulnar hand muscles with or without hypotrophy. Electrophysiological examination was performed by a proper protocol according to AAEM/AAN recommendations (1999). Two validated (DASH and BCTQ) and one newly proposed self‐administered questionnaires were used for patient‐oriented evaluation. Clinical severity was assessed with a 3‐stage scale (Antoniadis, 1997) and a 4‐stage scale (Giannini, 2001). Electrophysiological severity was quantified using a 5‐step neurophysiological classification (Padua, 2001) and a 13‐point neurophysiological score (Mondelli, 2000). Two hundred‐seven patients (218 limbs affected) were collected until October 2002. The females/males ratio was 1:1.9 and females were younger than males (mean age 44.5 and 52.5 yrs. respectively). Repetitive stress injury was reported as possible pathogenetic factor in 50.5% of cases and Carpal Tunnel Syndrome ‐ comorbidity was diagnosed in 22.5% of limbs without gender difference. Reduction of ulnar nerve motor conduction across the elbow was found in 86.2% of limbs. EMG neurogenic pattern in ulnar supplied hand muscles and digit‐wrist ulnar SAP abnormalities were respectively observed in 61.5% and 49.1% of cases. Pain (61%), associated with positive provocative test (p < 0.01), was equally distributed in each clinical classes and was related with higher BCTQ score (p < 0.001). DASH questionnaire showed the highest relation to clinical scale and electrophysiological score (p < 0.001). High relations were found among clinical scales, neurophysiological classification and electrophysiological score (p < 0.001). These preliminary results show a very good reliability of most measurements used for multiperspective assessment of UNE syndrome.