주관절부 척골신경병증에서 미국 전기진단의학회 진단 기준의 유용성 및 제한점
The Usefulness and Limitation of the AANEM Guidelines in Electrodiagnosis of Ulnar Neuropathy at the Elbow
김대환, 이태임, 김주섭, 박준성, 이재환, 구혜경,
소속 상세정보
김대환 ( Kim Dae-Hwan )
분당제생병원 재활의학과
이태임 ( Yi Tae-Im )
분당제생병원 재활의학과
김주섭 ( Kim Joo-Sup )
분당제생병원 재활의학과
박준성 ( Park Jun-Sung )
분당제생병원 재활의학과
이재환 ( Lee Jae-Hwan )
분당제생병원 재활의학과
구혜경 ( Koo Hye-Kyung )
분당제생병원 재활의학과
KMID : 0860920060080020097
Abstract
Objectives: To examine the usefulness and limitations of the American Association of Neuromuscular & Electrodianostic Medicine (AANEM) guidelines in electrodiagnosis of ulnar neuropathy at the elbow.
Methods: Electrodiagnostic records of 46 arms diagnosed with ulnar neuropathy at the elbow were reviewed retrospectively. We re-evaluated them according to AANEM guidelines.
Results: Among 46 cases, only 31 cases (67.4%) were consistent with AANEM guidelines of ulnar neuropathy at the elbow. Among 4 parameters of AANEM guidelines, parameters related to nerve conduction velocity (NCV) revealed high sensitivities(87.1%, 77.4%). Among other electrodiagnostic parameters, differences with contralateral motor NCV across the elbow(81.8%), small amplitude of ulnar sensory nerve action potential(71.4%), and abnormal electromyographic findings(74.2%) revealed relatively high sensitivities than others. There are significant positive correlations between the numbers of parameters correspondent for AANEM guidelines and the degree of abnormalities of some electrodiagnostic parameters. Most of cases inconsistent with AANEM guidelines revealed the electrodiagnostic findings suggestive of pure axonal injury or sensory nerve fibers involvement.
Conclusion: Despite of the ability to reflect of the disease severity, application of AANEM guidelines can bring about false-negative results. Thus, practitioners should consider to check other sensitive electrodiagnostic parameters together with AANEM guidelines
키워드
Elbow;Electrodiagnostic parameters;Sensitivity;Ulnar neuropathy
원문 및 링크아웃 정보
등재저널 정보