Electrophysiological and Ultrasonographic Evaluation of Palmar Digital Nerve Injury in Distal Finger
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Electrophysiological evaluation of distal lesions in the palmar digital branch of the median nerve presents a significant challenge. We present a case of lateral palmar digital neuropathy of the median nerve, which was confirmed through clinical, electrophysiological, and ultrasonographic assessments. A 54-year-old woman was referred to our electrophysiology laboratory for persistent numbness and a tingling sensation on the radial side of the distal phalanx of her left second finger. She had a laceration injury on the middle phalanx of the second finger and underwent neurorrhaphy of the lateral branch of the palmar digital nerve 8 months ago. Sensory nerve conduction studies, both antidromic and orthodromic, showed low amplitude responses for the lateral branch of the palmar digital nerve. Ultrasonography revealed swelling of this nerve branch within the middle phalanx of the second finger. When patients report sensory symptoms in a specific area, it is important to evaluate for potential cutaneous nerve injuries using electrophysiological studies. Additionally, high-resolution ultrasonography is a valuable tool for investigating small cutaneous nerve lesions, even in the distal finger.
Abstract
Electrophysiological evaluation of distal lesions in the palmar digital branch of the median nerve presents a significant challenge. We present a case of lateral palmar digital neuropathy of the median nerve, which was confirmed through clinical, electrophysiological, and ultrasonographic assessments. A 54-year-old woman was referred to our electrophysiology laboratory for persistent numbness and a tingling sensation on the radial side of the distal phalanx of her left second finger. She had a laceration injury on the middle phalanx of the second finger and underwent neurorrhaphy of the lateral branch of the palmar digital nerve 8 months ago. Sensory nerve conduction studies, both antidromic and orthodromic, showed low amplitude responses for the lateral branch of the palmar digital nerve. Ultrasonography revealed swelling of this nerve branch within the middle phalanx of the second finger. When patients report sensory symptoms in a specific area, it is important to evaluate for potential cutaneous nerve injuries using electrophysiological studies. Additionally, high-resolution ultrasonography is a valuable tool for investigating small cutaneous nerve lesions, even in the distal finger.
참고문헌 (10)
- Dobyns JH, "Digital nerve compression", Hand Clin, 8, pp.359~367 (1992)
- Zanette G, "An electrodiagnostic technique for assessing palmar proper digital nerves of the hand: normative data and clinical application", Muscle Nerve, 52, pp.972~980 (2015)
- Ueno T, "Sensory nerve conduction study with inching test in palmar digital neuropathy", Intern Med, 60, pp.469~472 (2021)
- Umans H, "Sonographic assessment of volar digital nerve injury in the context of penetrating trauma", AJR Am J Roentgenol, 194, pp.1310~1313 (2010)
- Yan A, "High-frequency ultrasonography of the digital and palmar nerve branches of the hand in peripheral nerve diseases", J Vis Exp, 185, pp.e63878~ (2022)
- Jun Soo Noh, "Palmar Digital Neuropathy With Anatomical Variation of Median Nerve: Usefulness of Orthodromic Technique: A Case Report", Annals of Rehabilitation Medicine, 43(3), pp.341~346 (2019), 대한재활의학회[DOI]
- Dumitru D, "Electrodiagnostic medicine", pp.180~ (2001), Hanley & Belfus
- Chang KV, "Ultrasound imaging for the cutaneous nerves of the extremities and relevant entrapment syndromes : from anatomy to clinical implications", J Clin Med, 7, pp.457~ (2018)
- Luzhansky ID, "Imaging in the repair of peripheral nerve injury", Nanomedicine(Lond), 14, pp.2659~2677 (2019)
- Martín Noguerol T, "Functional MR neurography in evaluation of peripheral nerve trauma and postsurgical assessment", Radiographics, 39, pp.427~446 (2019)
