Lumbrical‐interossei motor studies localize ulnar neuropathy at the wrist

Ulnar nerve entrapment at the wrist (UNW) is uncommon and often difficult to localize electrophysiologically. The difference between the motor latencies to the median‐innervated second lumbrical (2L) and ulnar‐innervated palmar interosseous (PI) (Diff 2L‐PI) has been shown to be of localizing value in patients with median neuropathy at the wrist. In the last year, we evaluated 2 patients with clinically definite ulnar neuropathy at the wrist. We performed motor studies to the 2L‐PI on the 2 patients and 12 disease controls with ulnar neuropathy at the elbow as follows: Using the same electrodes to record both the 2L and PI, the median and ulnar nerves were each stimulated supramaximally above the wrist using identical distances. In the disease control subjects, the Diff 2L‐PI was essentially the same as normal controls (mean [0.13], range [(−0.3)−0.4]). In both patients with UNW, the Diff 2L‐PI clearly supported the routine electrophysiological studies in localizing the lesion (ulnar latencies were 1.1 and 1.8 ms longer than the median latencies). We conclude that the lumbrical‐interosseous latency difference is useful in localizing ulnar nerve entrapment to the wrist. © 1996 John Wiley & Sons, Inc.

[1]  M. Kothari,et al.  Comparison of the flexed and extended elbow positions in localiziing ulnar neuropathy at the elbow , 1995, Muscle & nerve.

[2]  M. Kothari,et al.  The limitations of the dorsal ulnar cutaneous sensory response in patients with ulnar neuropathy at the elbow , 1995, Muscle & nerve.

[3]  J. Shefner,et al.  Sensory and mixed nerve conduction studies in the evaluation of ulnar neuropathy at the elbow , 1994, Muscle & nerve.

[4]  E. Logigian,et al.  Lumbrical and interossei recording in carpal tunnel syndrome , 1992, Muscle & nerve.

[5]  M. Ms.  Ulnar nerve compression at the wrist. Ulnar tunnel syndrome. , 1992 .

[6]  T. W. Wolff,et al.  Ulnar nerve compression in Guyon's canal caused by calcinosis in scleroderma. , 1991, The Journal of hand surgery.

[7]  B. Bailey,et al.  Accessory palmaris longus muscle causing ulnar nerve compression at the wrist. , 1991, The Journal of hand surgery.

[8]  M. Hoffman,et al.  Paired study of the dorsal cutaneous ulnar and superficial radial sensory nerves. , 1988, Archives of physical medicine and rehabilitation.

[9]  R. Olney,et al.  AAEE case report #15: Ulnar neuropathy at or distal to the wrist , 1988, Muscle & nerve.

[10]  S. Mackinnon,et al.  Anatomic Investigations of Nerves at the Wrist: II. Incidence of Fibrous Arch Overlying Motor Branch of Ulnar Nerve , 1988, Annals of plastic surgery.

[11]  R. Ehman,et al.  Deep branch ulnar neuropathy due to giant cell tumor , 1988, Neurology.

[12]  B. Shahani,et al.  Lurnbrical sparing in carpal tunnel syndrome , 1987, Neurology.

[13]  J. Morris,et al.  Ulnar neuropathy at the wrist: case report and review of literature. , 1985, Archives of physical medicine and rehabilitation.

[14]  S. Wainapel,et al.  Dorsal cutaneous ulnar nerve conduction. Diagnostic aid in ulnar neuropathy. , 1981, Archives of neurology.

[15]  J. Jabre.  Ulnar nerve lesions at the wrist , 1980, Neurology.

[16]  R. Gelberman,et al.  Acute ulnar neuropathy with fractures at the wrist. , 1978, The Journal of bone and joint surgery. American volume.

[17]  M. Finelli.  Mononeuropathy of the deep palmar branch of the ulnar nerve. A case occurring in a diabetic woman. , 1975, Archives of neurology.

[18]  P. B. Eckman,et al.  Ulnar neuropathy in bicycle riders. , 1975, Archives of neurology.

[19]  N. J. Cowen.  Hypothenar mass and ulnar neuropathy. A case report. , 1970, Clinical orthopaedics and related research.

[20]  E. McCLAIN,et al.  Ulnar-nerve compression syndromes at and below the wrist. , 1969, The Journal of bone and joint surgery. American volume.

[21]  C. Dupont,et al.  Ulnar-Tunnel Syndrome at the Wrist , 1965 .

[22]  H. Wolff,et al.  OCCUPATIONAL PRESSURE NEURITIS OF THE DEEP PALMAR BRANCH OF THE ULNAR NERVE , 1948 .

[23]  J. Hunt.  OCCUPATION NEURITIS OF THE DEEP PALMAR BRANCH OF THE ULNAR NERVE A WELL DEFINED CLINICAL TYPE OF PROFESSIONAL PALSY OF THE HAND , 1908 .