급성 압박성 노신경 마비에서 진단 및 예후 인자로서 근위부 운동신경전도검사의 유용성
Diagnostic and Prognostic Usefulness of Proximal Radial Motor Nerve Conduction Study in Acute Compressive Radial Neuropathy
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Objective: To demonstrate diagnostic and prognostic usefulness of electrodiagnostic study in evaluating acute compressive radial neuropathy. Methods: We reviewed the medical records of acute compressive radial neuropathy with electrodiagnostic study between January 2007 and December 2009, and we recruited 28 patients. We interviewed all the patients by telephone to find out the final neurologic status. Results: Female to male ratio was 4:24 and most of them had normal body mass index. The entire patient had good recovery and we could dichotomize to ‘Almost normal (24 cases)’ and ‘Good (4)’ group. Only 2 patients showed low amplitude of sensory nerve action potential of superficial radial nerve, but conduction block of radial nerve was demonstrated on 18 cases (64.3%) between elbow and Erb’s point. In clinical evaluation, initial motor grade of wrist and finger joint (MPJ) was important because recovery time of patients with MRC grade 2 or less showed significantly longer than that with MRC grade 3 or more (83.8±57.6 days vs. 37.1±19.7 days, p<0.05). The degree of radial nerve conduction block was related with recovery time of motor weakness (linear regression; β=-0.43 p<0.05). Conclusion: Radial motor nerve conduction study including Erb’s point stimulation is useful method to evaluate acute compressive radial neuropathy. Furthermore, it is also useful to predict the duration of motor weakness.
Abstract
Objective: To demonstrate diagnostic and prognostic usefulness of electrodiagnostic study in evaluating acute compressive radial neuropathy. Methods: We reviewed the medical records of acute compressive radial neuropathy with electrodiagnostic study between January 2007 and December 2009, and we recruited 28 patients. We interviewed all the patients by telephone to find out the final neurologic status. Results: Female to male ratio was 4:24 and most of them had normal body mass index. The entire patient had good recovery and we could dichotomize to ‘Almost normal (24 cases)’ and ‘Good (4)’ group. Only 2 patients showed low amplitude of sensory nerve action potential of superficial radial nerve, but conduction block of radial nerve was demonstrated on 18 cases (64.3%) between elbow and Erb’s point. In clinical evaluation, initial motor grade of wrist and finger joint (MPJ) was important because recovery time of patients with MRC grade 2 or less showed significantly longer than that with MRC grade 3 or more (83.8±57.6 days vs. 37.1±19.7 days, p<0.05). The degree of radial nerve conduction block was related with recovery time of motor weakness (linear regression; β=-0.43 p<0.05). Conclusion: Radial motor nerve conduction study including Erb’s point stimulation is useful method to evaluate acute compressive radial neuropathy. Furthermore, it is also useful to predict the duration of motor weakness.
참고문헌 (14)
- Haymeker W, "Peripheral nerve injuries, 1st ed", pp.264~272 (1953), W.B. Saunderss Co
- Hollinshead WH, "Functional anatomy of the limbs and back, 5th ed", pp.122~123 (1981), W.B. Saunderss Co
- Park MH, "Clinical and electrodiagnostic review of radial nerve paralysis", Medicine today, 34, pp.63~67 (1991)
- Ann Marie P, "Compressive radial neuropathies", Instructional Course Lecture, 49, pp.295~303 (2000)
- Bauwens P, "Electrodiagnosis revisited", Arch Phys Med, 42, pp.6~18 (1961)
- Gassel MM, "Diamantopoulos E: Pattern of conduction times in the distribution of the radial nerve", Neurology, 14, pp.222~231 (1964)
- Jebsen RH, "Motor conduction velocity in proximal distal segments of the radial nerve", Arch Med Phys Rehabil, 47, pp.597~602 (1966)
- Berry MM, "Nervous system. In Gray’s anatomy, 38th ed", pp.1266~1277 (2000), Churchill Livingstone
- Trojaborg W, "Rate of recovery in motor and sensory fibers of the radial nerve: Clinical and Electrophysiological aspect", J Neurol Neurosurg Psychiatry, 33, pp.625~638 (1970)
- Oh SJ, "Clinical Electromyography nerve conduction study, 3rd ed", pp.653~656 (2003), Lippincott Williams & Wilkins
- Preston DC, "Electromyography and neuromuscular disorders. Clinical-electrophysiologic correlations, 2nd ed", pp.327~342 (2005), Elsevier
- Malikowski T, "Prognostic values of electrodiagnostic studies in traumatic radial neuropathy", Muscle Nerve, 36, pp.364~367 (2007)
- Watson BV, "Quantitation of axon loss and conduction block in acute radial nerve palsies", Muscle Nerve, 12, pp.768~773 (1992)
- Beekman R, "Ulnar neuropathy at the elbow. Follow-up and prognostic factors determining outcome", Neurology, 63, pp.1675~1680 (2004)