Diagnosis and Treatment of the Delayed Ulnar Nerve Neuritis
Nobuji Miwa, Hideki Sonoda, M. Simizu
Abstract
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Nobuji Miwa, Hideki Sonoda, M. Simizu
Abstract
Open-access reader
Three men of sixth decade, who had hypesthesia and paresthesia at the ulnar nerve distributions and atrophy of the hand muscles were reported.Everyone had evident osteoarthritis in the lower cervical vertebrae and in the right elbow joint.Though osteophytic formation at the ulnar side of the trochlea was similar grade in three men, only one had paresis of the right ulnar nerve due to campression by the osteophyte.In one of remains, surgical exposure of the right ulnar nerve showed dislocation of this nerve onto the tip of the medial epicondyle and slight cicatrical constriction at the proximal level of the epicondyle.The last one had the history that diagnosed as delayed neuritis of the right ulnar nerve and treated with no improvement. His symptomes and signs seemed to be those of due to peripheral lesion and oblique roentgenograms revealed no narrowed intervertebral canal between the seventh cervical vertebra and first thracal vertebra. But in lower part of the pectral major muscle there exist slight muscle atrophy. Electromyography showed polyphasic motor unit voltages and giant oscillations in this portion. Moreover, myelogram revealed defect of the nerve root contour of the eighth cervical nerve.After surgery, decompression of this nerve root was performed, immediate sensory improvement was obtained.
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Three men of sixth decade, who had hypesthesia and paresthesia at the ulnar nerve distributions and atrophy of the hand muscles were reported.Everyone had evident osteoarthritis in the lower cervical vertebrae and in the right elbow joint.Though osteophytic formation at the ulnar side of the trochlea was similar grade in three men, only one had paresis of the right ulnar nerve due to campression by the osteophyte.In one of remains, surgical exposure of the right ulnar nerve showed dislocation of this nerve onto the tip of the medial epicondyle and slight cicatrical constriction at the proximal level of the epicondyle.The last one had the history that diagnosed as delayed neuritis of the right ulnar nerve and treated with no improvement. His symptomes and signs seemed to be those of due to peripheral lesion and oblique roentgenograms revealed no narrowed intervertebral canal between the seventh cervical vertebra and first thracal vertebra. But in lower part of the pectral major muscle there exist slight muscle atrophy. Electromyography showed polyphasic motor unit voltages and giant oscillations in this portion. Moreover, myelogram revealed defect of the nerve root contour of the eighth cervical nerve.After surgery, decompression of this nerve root was performed, immediate sensory improvement was obtained.
Key concepts: Medicine, Ulnar nerve, Anatomy, Epicondyle, Elbow, Nerve root, Cubital tunnel, Electromyography