Selten untersuchte Nerven und Innervationsanomalien

Abstract

The repertoire of nerve conduction studies in most neurophysiological laboratories comprises the major motor and sensory distal nerves of the upper and lower extremities. However, several additional nerves are amenable to nerve conduction studies with well reproducible results, and their examination may be useful to investigate specific clinical problems. Other uncommon nerve conduction studies do not produce consistent results, restricting their clinical usefulness. In clinical practice, nerve conduction studies of the axillary nerve, the phrenic nerve, the lateral femoral cutaneous nerve, the femoral nerve, the saphenous nerve and the plantar nerves are of some clinical utility. This review describes the techniques and the clinical use of nerve conduction studies of these nerves. Another topic of this review is variations of the normal motor nerve anatomy of the extremities. In subjects with a Martin-Gruber anastomosis, motor nerve fibres of the ulnar nerve follow the median nerve at the level of the elbow and cross to the ulnar nerve at the forearm. The Martin-Gruber anastomosis is of particular clinical importance since its existence may mimic a partial motor conduction block of the ulnar nerve at the level of the forearm. It may also lead to the erroneous localisation of proximal lesions of the median and ulnar nerve. Other anatomic variants are also discussed.