척골신경 손상 환자에서 완전 신경 전도차단으로 혼동될 수 있는 근위부 마틴-그루버 문합 1예
A Case of Proximal Martin-Gruber Anastomosis Confused with Complete Conduction Block at the Elbow of Ulnar Nerve in a Patient with Ulnar Neuropathy
3
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Martin-Gruber anastomosis (MGA) is median-to-ulnar nerve communication in the forearm and the most common congenital anomalous anastomosis. There were few reports about concomitant ulnar neuropathy and MGA. We present a case of ulnar neuropathy combined with proximal MGA. The location of anastomosis from median-to-ulnar nerve was proximal to below-elbow stimulation point along the ulnar nerve, which made it difficult to differentiate MGA from simple conduction block state of ulnar nerve around the elbow. To recognize proximal MGA during routine nerve conduction study in patient with ulnar neuropathy, meticulous physical examination is required and proximal nerve stimulation such as axilla should be added during nerve conduction study.
Abstract
Martin-Gruber anastomosis (MGA) is median-to-ulnar nerve communication in the forearm and the most common congenital anomalous anastomosis. There were few reports about concomitant ulnar neuropathy and MGA. We present a case of ulnar neuropathy combined with proximal MGA. The location of anastomosis from median-to-ulnar nerve was proximal to below-elbow stimulation point along the ulnar nerve, which made it difficult to differentiate MGA from simple conduction block state of ulnar nerve around the elbow. To recognize proximal MGA during routine nerve conduction study in patient with ulnar neuropathy, meticulous physical examination is required and proximal nerve stimulation such as axilla should be added during nerve conduction study.
참고문헌 (13)
- Rodriguez-Niedenfuhr M, "Martin-Gruber anastomosis revisited", Clin Anat, 15, pp.129~134 (2002)
- Erdem HR, "Electrophysiological evaluation of the incidence of martin-gruber anastomosis in healthy subjects", Yonsei Med J, 43, pp.291~295 (2002)
- Kazakos KJ, "Dimitrakopoulou A, Verettas DA: Anastomosis between the median and ulnar nerve in the forearm. An anatomic study and literature review", Acta Orthop Belg, 71, pp.29~35 (2005)
- Rodriguez-Niedenfuhr M, "Intramuscular Martin-Gruber anastomosis", Clin Anat, 15, pp.135~138 (2002)
- Lee KS, "An anatomic study of the Martin-Gruber anastomosis: electrodiagnostic implications", Muscle Nerve, 31, pp.95~97 (2005)
- 김동휘, "완전 척골신경병증에서 Martin-Gruber 문합 - 증례 보고 -", 대한근전도전기진단의학회지, 4, pp.97~110 (2002)
- Van Tieghem J, "Martin-Gruber anastomosis: the explanation for late diagnosis of severe ulnar nerve lesions at the elbow", Electromyogr Clin Neurophysiol, 27, pp.13~18 (1987)
- van Dijk JG, "What is the best way to assess focal slowing of the ulnar nerve?", Clin Neurophysiol, 112, pp.286~293 (2001)
- Wee AS, "Correlation between the biceps brachii muscle bulk and the size of its evoked compound muscle action potential", Electromyogr Clin Neurophysiol, 46, pp.79~82 (2006)
- Tsai YA, "Electrophysiologic findings and muscle strength grading in brachioplexopathies", Microsurgery, 22, pp.11~15 (2002)
- Marras C, "Proximal Martin-Gruber anastomosis mimicking ulnar neuropathy at the elbow", Muscle Nerve, 22, pp.1132~1135 (1999)
- Rigler I, "Impact of electromyographic findings on choice of treatment and outcome", Eur J Neurol, 14, pp.783~787 (2007)
- Sarikcioglu L, "Median and ulnar nerve communication in the forearm: an anatomical and electrophysiological study", Med Sci Monit, 9, pp.BR351~BR356 (2003)