Pre- and Postoperative Electrodiagnostic and Operative Findings on Atypical Fascicular Involvement of Ulnar Neuropathy at the Elbow: A Case Report
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A 46-year old male was referred with complaint of tingling sensation of right 4, 5th fingers which aggravated on elbow flexion. He has history of proximal radius fracture six months ago. The standard nerve conduction studies were all normal including ulnar segmental motor conduction study with abductor digiti minimi and first dorsal interosseous recordings and ulnar sensory segmental studies across the elbow. However, the segmental motor conduction study demonstrated amplitude drop with above elbow stimulation with needle recording in flexor carpi ulnaris and flexor digitorum profundus that showed abnormal findings in needle EMG. The segmental sensory conduction study of dorsal ulnar cutaneous nerve also revealed amplitude reduction with above elbow stimulation. Imaging studies of the elbow uncovered bony fragment around the medial epicondyle. The patient received surgery: osseous fragment excision, neurolysis and anterior transposition of the ulnar nerve. In post-operative study, previous electrodiagnostic findings were all normalized with clinical improvement.
Abstract
A 46-year old male was referred with complaint of tingling sensation of right 4, 5th fingers which aggravated on elbow flexion. He has history of proximal radius fracture six months ago. The standard nerve conduction studies were all normal including ulnar segmental motor conduction study with abductor digiti minimi and first dorsal interosseous recordings and ulnar sensory segmental studies across the elbow. However, the segmental motor conduction study demonstrated amplitude drop with above elbow stimulation with needle recording in flexor carpi ulnaris and flexor digitorum profundus that showed abnormal findings in needle EMG. The segmental sensory conduction study of dorsal ulnar cutaneous nerve also revealed amplitude reduction with above elbow stimulation. Imaging studies of the elbow uncovered bony fragment around the medial epicondyle. The patient received surgery: osseous fragment excision, neurolysis and anterior transposition of the ulnar nerve. In post-operative study, previous electrodiagnostic findings were all normalized with clinical improvement.
참고문헌 (10)
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