Ulnar neuropathy at the elbow in computer keyboard operators

Abstract

This case series sought to determine the prevalence of ulnar neuropathy at the elbow (UNE) by using electrophysiologic criteria among all computer keyboard operators (CKOs) referred over a four-year period (1995-1999) for electrodiagnosis (EDX) due to clinical suspicion of focal upper limb neuropathies. All CKOs referred to an EDX laboratory for suspicion of focal upper limb neuropathies primarily from private practice physicians, mostly hand surgeons, and an occupational medicine clinic. All 148 CKOs underwent NCV studies of the upper limbs, which included segmental studies of the ulnar nerve and were questioned for the presence and distribution pattern of paresthesias in the symptomatic upper limb(s). The CKOs provided the electromyographer with subjective descriptions of their workstation configuration, layout, and basic office equipment. Focal ulnar neuropathy at the elbow (UNE) was identified in 105 out of 148 CKOs referred to an EDX laboratory for clinical suspicion of upper limb focal neuropathies. Compared with the more prevalent diagnosis of carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow should also be considered among CKOs referred for EDX testing because of suspicion of focal upper limb neuropathies. Clinicians evaluating CKOs for suspicion of focal upper limb neuropathies should routinely ask about symptoms of ulnar neuropathy.