OBJECTIVE: To examine the usefulness of the second lumbrical-interosseous (2L-INT) distal motor latency (DML) comparison test in localizing median neuropathy to the wrist in patients with absent median sensory and motor response in routine nerve conduction studies. METHODS: Electrodiagnostic results from 1,705 hands of patients with carpal tunnel syndrome (CTS) symptoms were reviewed retrospectively. All subjects were evaluated using routine nerve conduction studies: median sensory conduction recorded from digits 1 to 4, motor conduction from the abductor pollicis brevis muscle, and the 2L-INT DML comparison test. RESULTS: Four hundred and one hands from a total of 1,705 were classified as having severe CTS. Among the severe CTS group, 56 hands (14.0%) showed absent median sensory and motor response in a routine nerve conduction study, and, of those hands, 42 (75.0%) showed an abnormal 2L-INT response. CONCLUSION: The 2L-INT DML comparison test proved to be a valuable electrodiagnostic technique in localizing median mononeuropathy at the wrist, even in the most severe CTS patients.
Carpal Tunnel Syndrome* ; Hand ; Humans ; Median Neuropathy ; Mononeuropathies ; Neural Conduction ; Retrospective Studies ; Wrist

Saphenous mononeuropathy is an uncommon neuropathy in clinical condition, which may incur from various surgical procedures, direct trauma, or entrapment, and most frequently involves at the adductor canal, or Hunter's canal. A 17-year old female, who was majoring in ballet, visited our rehabilitation clinic for numbness in the medial aspect of the left lower leg for the previous 9 months, without weakness. The electrodiagnostic study revealed only a delayed small potential in the left saphenous nerve. MRI examination showed soft tissue swelling in the medial side of the left knee. Accordingly, we diagnosed the patient with saphenous mononeuropathy around the knee, without lumbar plexopathy or femoral neuropathy. We report a case of saphenous mononeuropathy which developed after repetitive compression on the medial side of the knee without any other iatrogenic injury, and include a review of the relevant literature.
Female ; Femoral Neuropathy ; Humans ; Hypesthesia ; Knee ; Leg ; Mononeuropathies

No abstract available.
Mononeuropathies ; Purpura

Sciatic neuropathy is caused by a wide spectrum of etiologies including trauma, compression, metabolic, infectious, and inflammatory conditions. Diabetic mononeuropathy remains one of the more elusive disease manifestations due to lack of large-scale prevalence studies and varied classification schemes. In this study, we present the case of a 48-year-old female diagnosed with diabetic mononeuropathy involving the sciatic nerve. Electromyography and nerve condition studies showed left sciatic neuropathy, and magnetic resonance imaging of the pelvis revealed an elarged left sciatic nerve. The patient was managed by controlling the blood glucose level and by therapeutic exercise. This case aims to achieve a better understanding of mononeuropathies occuring in diabetes.

Human ; Female ; Middle Aged ; Diabetes Mellitus ; Blood Glucose ; Cross-sectional Studies ; Diabetic Neuropathies ; Electromyography ; Magnetic Resonance Imaging ; Mononeuropathies ; Pelvis ; Sciatic Nerve ; Sciatic Neuropathy

OBJECTIVE: The purpose of this study was to determine the natural history of symptomatic hands without electrodiagnostic evidence of carpal tunnel syndrome (CTS). METHOD: This study was comprised of 88 hands of 49 subjects with symptoms consistent with CTS without median mononeuropathy who were recruited during a community health examination and followed after two years. 88 hands of 44 people with age and sex-matched healthy controls were followed for comparison. Symptoms and electrodiagnostic findings were compared between the two groups. RESULTS: 62 hands of the symptomatic group had persistent symptoms after 2 years while 16 hands of the control group had symptoms consistent with CTS. Median motor distal latencies were significantly delayed after two years in the symptomatic group (p<0.05). Median sensory latencies were also delayed in the symptomatic group, but this was not statistically significant (p=0.064). The occurrence rate of median mononeuropathy at wrist was significantly higher in the symptomatic group than in the control group (13.6% vs. 2.3%)(p<0.05). CONCLUSION: The results of this study suggested that a significant number of symptomatic hands without electrodiagnostic evidence of CTS may have persistent symptoms and may progress to electrodiagnostically evident CTS.
Carpal Tunnel Syndrome* ; Follow-Up Studies* ; Hand* ; Mononeuropathies ; Natural History ; Wrist

OBJECTIVE: To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients. METHODS: One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion. RESULTS: The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove. CONCLUSION: Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy.
Diabetes Mellitus ; Diabetic Neuropathies ; Elbow* ; Electrodiagnosis ; Forearm ; Humans ; Mononeuropathies ; Prevalence ; Ulnar Nerve ; Ulnar Neuropathies*

Sciatic nerve palsy is the most common nerve injury associated with acetabular fracture and dislocation, but femoral nerve injury is known to be very rare because of relative protected position of nerve between the iliacus and psoas muscle, and as far as we know only one report was noted in English about combined femoral and sciatic nerve injury associated with acetabular fracture and dislocation, so we hereby report a case of combined femoral and sciatic nerve palsy associated with acetabular fracture and dislocation.
Acetabulum* ; Dislocations* ; Femoral Nerve ; Psoas Muscles ; Sciatic Nerve* ; Sciatic Neuropathy*

OBJECTIVE: To determine the frequency, involved nerves and sites of entrapment neuropathy in string players. METHOD: The subjects were 24 string playing musicians and age matched 24 normal controls. Questionnaire, physical examination were taken in the musicians and the electrodiagnostic study was performed in both the musician and the control groups. Electrodiagnostic study included nerve conduction study of median and ulnar nerves. The distal motor latency, segmental motor conduction velocity, distal sensory latency, and amplitude of sensory nerve action potentials were measured. Each parameter of nerve conduction study was compared in two groups and was correlated to the string playing duration. RESULTS: Three musicians (12.5%) were diagnosed as entrapment neuropathy: One, left ulnar neuropathy at the elbow and the wrist and left median neuropathy at the wrist; Two, left ulnar neuropathy at the elbow. Ulnar motor conduction velocity of right forearm segment and left elbow segment were significantly reduced in the musicians compared to those of the controls (P<0.05). The distal sensory latency of left ulnar nerve was significantly prolonged in musicians compared to that of the controls (P<0.05). The string playing duration significantly correlated with the distal motor latency of right median nerve (R=0.632, P<0.05) and the distal sensory latency of left median nerve (R=0.518, P<0.05). CONCLUSIONS: These results suggest that some entrapment neuropathies could be developed due to cumulative trauma in string players. Elbow and wrist segment of left ulnar nerve, forearm segment of right ulnar nerve are possible sites of entrapment neuropathy in string players.
Action Potentials ; Elbow ; Forearm ; Median Nerve ; Median Neuropathy ; Nerve Compression Syndromes ; Neural Conduction ; Physical Examination ; Surveys and Questionnaires ; Ulnar Nerve ; Ulnar Neuropathies ; Wrist

Ulnar neuropathy at the wrist is rarely reported as complications of carpal tunnel release. Since it can sometimes be confused with recurrent median neuropathy at the wrist or ulnar neuropathy at the elbow, an electrodiagnostic study is useful for detecting the lesion in detail. We present a case of a 51-year-old woman with a two-week history of right ulnar palm and 5th digit tingling sensation that began 3 months after open carpal tunnel release surgery of the right hand. Electrodiagnostic tests such as segmental nerve conduction studies of the ulnar nerve at the wrist were useful for localization of the lesion, and ultrasonography helped to confirm the presence of the lesion. After conservative management, patient symptoms were progressively relieved. Combined electrodiagnostic studies and ultrasonography may be helpful for diagnosing and detecting ulnar neuropathies of the wrist following carpal tunnel release surgery.
Carpal Tunnel Syndrome ; Elbow ; Female ; Hand ; Humans ; Median Neuropathy ; Middle Aged ; Neural Conduction ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies ; Wrist

No abstract available.
Mononeuropathies* ; Systemic Vasculitis ; Vasculitis*