Download PDF
Semin Neurol 2005; 25(2): 196-203
DOI: 10.1055/s-2005-871328
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Electrodiagnosis in Common Mononeuropathies and Plexopathies

Devanand Jillapalli1 , Jeremy M. Shefner1
  • 1Department of Neurology, Upstate Medical University, Syracuse, New York
Further Information

Publication History

Publication Date:
03 June 2005 (online)

    Permissions and Reprints

ABSTRACT

Electrodiagnosis has a prominent role in the diagnosis of common entrapment neuropathies (carpal tunnel syndrome and ulnar neuropathy at the elbow) and plexopathies (idiopathic brachial plexopathy and diabetic lumbar radiculoplexopathy). The relevant anatomy and pathology of these disorders is reviewed in the context of electrodiagnosis and prognosis.

KEYWORDS

Carpal tunnel syndrome - diabetic amyotrophy - diabetic lumbosacral radiculoplexopathy - idiopathic brachial plexopathy - median neuropathy - Parsonage-Turner syndrome - ulnar neuropathy

REFERENCES

  • 1 Cornblath D R, Sumner A J, Daube J et al.. Conduction block in clinical practice.  Muscle Nerve. 1991;  14 869-871
    PubMedGoogle Scholar
  • 2 Rhee E K, England J D, Sumner A J. A computer simulation of conduction block: effects produced by actual block versus interphase cancellation.  Ann Neurol. 1990;  28 146-156
    CrossrefPubMedGoogle Scholar
  • 3 Kimura J. Facts, fallacies and fantasies of nerve conduction studies: twenty-first annual Edward H. Lambert lecture.  Muscle Nerve. 1997;  20 777-787
    PubMedGoogle Scholar
  • 4 Seddon H J. Three types of nerve injury.  Brain. 1943;  66 237-288
    CrossrefPubMedGoogle Scholar
  • 5 Chaudhry V, Cornblath D R. Wallerian degeneration in human nerves: serial electrophysiological studies.  Muscle Nerve. 1992;  15 687-693
    CrossrefPubMedGoogle Scholar
  • 6 Jablecki C K, Andary M T, Floeter M K et al.. Practice parameter: Electrodiagnostic studies in carpal tunnel syndrome.  Neurology. 2002;  58 1589-1592
    CrossrefPubMedGoogle Scholar
  • 7 Jablecki C K, Andary M T, Yuen T et al.. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome.  Muscle Nerve. 1993;  16 1392-1414
    CrossrefPubMedGoogle Scholar
  • 8 Kimura I, Ayyar D R. The carpal tunnel syndrome: electrophysiological aspects of 639 symptomatic extremities.  Electromyogr Clin Neurophysiol. 1985;  25 151-164
    PubMedGoogle Scholar
  • 9 Thomas J E, Lambert E H, Cseuz K A. Electrodiagnostic aspects of carpal tunnel syndrome.  Arch Neurol. 1967;  16 635-641
    PubMedGoogle Scholar
  • 10 Concannon M J, Gainor B, Petroski G et al.. The predictive value of electrodiagnostic studies in Carpal tunnel syndrome.  Plast Reconstr Surg. 1997;  100 1452-1458
    CrossrefPubMedGoogle Scholar
  • 11 Tackmann W, Kaeser H E, Magun H G. Comparison of orthodromic and antidromic sensory nerve conduction velocity measurements in the carpal tunnel syndrome.  J Neurol. 1981;  224 257-266
    PubMedGoogle Scholar
  • 12 Kimura J. A method for determining median nerve conduction velocity across the carpal tunnel.  J Neurol Sci. 1978;  38 1-10
    CrossrefPubMedGoogle Scholar
  • 13 Kaul M P, Pagel K J. Value of lumbrical-interosseous technique in carpal tunnel syndrome.  Am J Phys Med Rehabil. 2002;  81 691-695
    CrossrefPubMedGoogle Scholar
  • 14 Preston D C, Logigian E L. Lumbrical and interossei recording in carpal tunnel syndrome.  Muscle Nerve. 1992;  15 1253-1257
    PubMedGoogle Scholar
  • 15 Uncini A, Lange D J, Solomon M et al.. Ring finger testing in carpal tunnel syndrome: a comparative study of diagnostic utility.  Muscle Nerve. 1989;  12 735-741
    PubMedGoogle Scholar
  • 16 Buschbacher R. Mixed nerve conduction studies of the median and ulnar nerves.  Am J Phys Med Rehabil. 1999;  78 S69-S74
    CrossrefPubMedGoogle Scholar
  • 17 Johnson E W, Sipski M, Lammertse T. Median and radial sensory latencies to digit 1: Normal values and usefulness in carpal tunnel syndrome.  Arch Phys Med Rehabil. 1987;  68 140-141
    PubMedGoogle Scholar
  • 18 Preston D C. Distal median neuropathies.  Neurol Clin. 1999;  17 407-424
    CrossrefPubMedGoogle Scholar
  • 19 Cioni R, Passero S, Paradiso C et al.. Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome.  J Neurol. 1989;  236 208-213
    CrossrefPubMedGoogle Scholar
  • 20 Amoiridis G. Median-ulnar nerve communications and anomalous innervation of the intrinsic hand muscles: an electrophysiological study.  Muscle Nerve. 1992;  15 576-579
    CrossrefPubMedGoogle Scholar
  • 21 Uchida Y, Sugioka Y. Electrodiagnosis of Martin-Gruber connection and its clinical importance in peripheral nerve surgery.  J Hand Surg [Am]. 1992;  17 54-59
    PubMedGoogle Scholar
  • 22 Gutmann L, Gutierrez A, Riggs J. The contribution of median-ulnar communications in the diagnosis of mild carpal tunnel syndrome.  Muscle Nerve. 1986;  9 319-321
    PubMedGoogle Scholar
  • 23 Preston D C, Shapiro B E. Anomalous innervations. In: Preston DC, Shapiro BE Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations. Newton, MA; Butterworth-Heinemann 1998: 77-83
    Google Scholar
  • 24 Moore J S. The occupational medicine physician’s view of proximal ulnar neuropathies: epidemiology, pathogenesis, and work relatedness. AAEM Plenary session: Broadening our view of compressive neuropathies: a 360 degree approach to the ulnar nerve. Toronto, Canada. 2002: 1-12
    Google Scholar
  • 25 Campbell W W, Pridgeon R M, Riaz G et al.. Variations in anatomy of the ulnar nerve at the cubital tunnel: pitfalls in the diagnosis of the ulnar neuropathy at the elbow.  Muscle Nerve. 1991;  14 733-738
    PubMedGoogle Scholar
  • 26 Anonymous. Practice parameter: electrodiagnostic studies in ulnar neuropathy at the elbow.  Neurology. 1999;  52 688-690
    PubMedGoogle Scholar
  • 27 Campbell W W. Electrophysiological approaches to the diagnosis and assessment of ulnar neuropathy: a historical and literature. AAEM Plenary session: Broadening our view of compressive neuropathies: a 360 degree approach to the ulnar nerve. Toronto, Canada. 2002: 13-21
    Google Scholar
  • 28 Childress H M. Recurrent ulnar nerve dislocation at the elbow.  Clin Orthop. 1975;  108 168-173
    PubMedGoogle Scholar
  • 29 Tackmann W, Vogel P, Kaeser H E et al.. Sensitivity and localizing significance of motor and sensory electroneurographic parameters in the diagnosis of ulnar nerve lesions at the elbow.  J Neurol. 1984;  231 204-211
    PubMedGoogle Scholar
  • 30 Raynor E M, Shefner J M, Preston D C et al.. Sensory and mixed nerve conduction studies in the evaluation of ulnar neuropathy at the elbow.  Muscle Nerve. 1994;  17 785-792
    PubMedGoogle Scholar
  • 31 Jillapalli D, Bradshaw D Y, Shefner J M. Motor unit number estimation in Focal Conduction Block.  Muscle Nerve. 2003;  27 676-681
    PubMedGoogle Scholar
  • 32 Campbell W W, Pridgeon R M, Riaz G et al.. Sparing of the flexor carpi ulnaris in ulnar neuropathy at the elbow.  Muscle Nerve. 1989;  12 965-967
    PubMedGoogle Scholar
  • 33 Stewart J D. The variable clinical manifestation of ulnar neuropathies at the elbow.  J Neurol Neurosurg Psychiatry. 1987;  50 252-258
    PubMedGoogle Scholar
  • 34 Venkatesh S, Kothari M J, Preston D C. The limitations of the dorsal ulnar cutaneous sensory response in patients with ulnar neuropathy at the elbow.  Muscle Nerve. 1995;  18 345-347
    PubMedGoogle Scholar
  • 35 Botte M J, Cohen M S, Lavernia C J et al.. The dorsal branch of the ulnar nerve: an anatomic study.  J Hand Surg [Am]. 1990;  15 603-607
    PubMedGoogle Scholar
  • 36 Parsonage M J, Turner J W. Neuralgic amyotrophy: the shoulder girdle syndrome.  Lancet. 1948;  1 973-978
    CrossrefPubMedGoogle Scholar
  • 37 Wilbourn A J. Brachial plexopathy. In: Katirji B, Kaminski HJ, Preston DC, et al Neuromuscular Disorders in Clinical Practice. Woburn, MA; Butterworth-Heinemann 2002: 884-906
    Google Scholar
  • 38 England J D, Sumner A J. Neuralgic amyotrophy: an increasingly diverse entity.  Muscle Nerve. 1987;  10 60-68
    CrossrefPubMedGoogle Scholar
  • 39 Bromberg M B, Jaros L. Symmetry of normal motor and sensory nerve conduction measurements.  Muscle Nerve. 1998;  21 498-503
    PubMedGoogle Scholar
  • 40 Olney R K. AAEM minimonograph #38: neuropathies in connective tissue disease.  Muscle Nerve. 1992;  15 531-542
    PubMedGoogle Scholar
  • 41 Ferrante M A, Wilbourn A J. The utility of various sensory conduction responses in assessing brachial plexopathies.  Muscle Nerve. 1995;  18 879-889
    PubMedGoogle Scholar
  • 42 Ferrante M A, Wilbourn A J. Electrodiagnostic approach to the patient with suspected brachial plexopathy.  Neurol Clin. 2002;  20 423-450
    CrossrefPubMedGoogle Scholar
  • 43 Kimura I, Ayyar D R. Sensory nerve conduction study in the medial antebrachial cutaneous nerve.  Tohoku J Exp Med. 1984;  142 461-466
    PubMedGoogle Scholar
  • 44 Seror P. The medial antebrachial cutaneous nerve: antidromic and orthodromic conduction studies.  Muscle Nerve. 2002;  26 421-423
    CrossrefPubMedGoogle Scholar
  • 45 Buschbacher R, Koch J, Emsley C et al.. Electrodiagnostic reference values for the lateral antebrachial cutaneous nerve: standardization of a 10 cm distance.  Arch Phys Med Rehabil. 2000;  81 1563-1566
    CrossrefPubMedGoogle Scholar
  • 46 Lambert E H. Diagnostic value of electrical stimulation of motor nerves.  Electroencephalogr Clin Neurophysiol Suppl. 1962;  22 9-16
    PubMedGoogle Scholar
  • 47 Wilbourn A J, Aminoff M J. AAEE minimonograph #32: the electrophysiologic examination in patients with radiculopathies.  Muscle Nerve. 1988;  11 1099-1114
    CrossrefPubMedGoogle Scholar
  • 48 Tsairis P, Dyck P J, Mulder D W. Natural history of brachial plexus neuropathy: report on 99 cases.  Arch Neurol. 1972;  27 109-117
    CrossrefPubMedGoogle Scholar
  • 49 Watson B V, Nicolle M W, Brown J D. Conduction block in neuralgic amyotrophy.  Muscle Nerve. 2001;  24 559-563
    PubMedGoogle Scholar
  • 50 Garland H. Diabetic amyotrophy.  BMJ. 1955;  2 1287-1290
    PubMedGoogle Scholar
  • 51 Garland H. Diabetic amyotrophy.  Br J Clin Pract. 1961;  15 9-13
    PubMedGoogle Scholar
  • 52 Locke S, Lawrence D G, Legg M A. Diabetic amyotrophy.  Am J Med. 1963;  34 775-785
    CrossrefPubMedGoogle Scholar
  • 53 Chokroverty S, Reyes M G, Rubino F A et al.. The syndrome of diabetic amyotrophy.  Ann Neurol. 1977;  2 181-194
    CrossrefPubMedGoogle Scholar
  • 54 Preston D C, Shapiro B E. Lumbosacral plexopathy. In: Preston DC, Shapiro BE Electromyography and Neuromuscular Disorders: Clinical-Electrophysiologic Correlations Newton, MA; Butterworth-Heinemann 1998: 471-489
    Google Scholar
  • 55 Wainapel S F, Kim D J, Ebel A. Conduction studies of the saphenous nerve in healthy subjects.  Arch Phys Med Rehabil. 1978;  59 316-319
    PubMedGoogle Scholar
  • 56 Said G, Goulon-Goeau C, Lacroix C et al.. Nerve biopsy findings in different patterns of proximal diabetic neuropathy.  Ann Neurol. 1994;  35 559-569
    CrossrefPubMedGoogle Scholar
  • 57 Williams I R, Mayer R F. Subacute proximal diabetic neuropathy.  Neurology. 1976;  26 108-116
    PubMedGoogle Scholar
  • 58 Date E S, Mar E Y, Bugola M R et al.. The prevalence of lumbar paraspinal spontaneous activity in asymptomatic subjects.  Muscle Nerve. 1996;  19 350-354
    CrossrefPubMedGoogle Scholar

Devanand JillapalliM.D. 

Department of Neurology, Upstate Medical University, 750 E

Adams Street, Syracuse, NY 13210

      >