Ulnar nerve at the elbow – normative nerve conduction study

Radim Mazanec,Jan Latta,Pavel Otruba,Pavel Urban,Hana Matulová,Bohumír Procházka,Marie Nakládalová,Petr Ridzoň,Edvard Ehler

doi:10.1186/1749-7221-8-2

Abstract

IntroductionA goal of our work was to perform nerve conduction studies (NCSs) of the ulnar nerve focused on the nerve conduction across the elbow on a sufficiently large cohort of healthy subjects in order to generate reliable reference data.MethodsWe examined the ulnar nerve in a position with the elbow flexion of 90o from horizontal. Motor response was recorded from the abductor digiti minimi muscle (ADM) and the first dorsal interosseous muscle (FDI).ResultsIn our sample of 227 healthy volunteers we have examined 380 upper arms with the following results: amplitude (Amp)-CMAP(wrist) for ADM 9.6 ± 2.3 mV, MNCV at the forearm 60.4 ± 5.2 m/s, MNCV across the elbow 57.1 ± 5.9 m/s.DiscussionOur study showed that motor NCSs of the ulnar nerve above elbow (AE) and below elbow (BE) in a sufficiently large cohort using methodology recommended by AANEM gave results well comparable for registration from FDI and ADM.

Highlights

A goal of our work was to perform nerve conduction studies (NCSs) of the ulnar nerve focused on the nerve conduction across the elbow on a sufficiently large cohort of healthy subjects in order to generate reliable reference data
Subjects with Martin-Gruber anastomosis were not considered eligible for the study, because of the influence of the anomaly on the Compound muscle action potential (CMAP) amplitude.Eventually, 380 extremities entered into the normative database
Comparison of CMAP amplitudes in the right and left ulnar nerve (UNE) recorded from abductor digiti minimi muscle (ADM) and first dorsal interosseous muscle (FDI) and comparison of CMAP amplitudes in the dominant and non-dominant hands Table 2, 3, 4, 5

Summary

Introduction

A goal of our work was to perform nerve conduction studies (NCSs) of the ulnar nerve focused on the nerve conduction across the elbow on a sufficiently large cohort of healthy subjects in order to generate reliable reference data. Methods: We examined the ulnar nerve in a position with the elbow flexion of 90o from horizontal. Reliable reference data for parameters of electrophysiological examination of the ulnar nerve (UNE) are prerequisite for detection of abnormality in UNE lesions. The technique of the UNE electrophysiological examination is associated with an array of methodical problems, which have been handled differently by individual authors. Indication for referral to surgery should be based on feasible and reproducible parameters [1,2,3,4]

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Conclusion