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. 2015 Dec 29;7(3):6207.
doi: 10.4081/ni.2015.6207.

Palm to Finger Ulnar Sensory Nerve Conduction

Eduardo Davidowich  1 , Osvaldo J M Nascimento  1 , Marco Orsini  1 , Camila Pupe  1 , Bruno Pessoa  1 , Caroline Bittar  1 , Karina Lebeis Pires  1 , Carlos Bruno  1 , Bruno Mattos Coutinho  1 , Olivia Gameiro de Souza  1 , Pedro Ribeiro  2 , Bruna Velasques  2 , Juliana Bittencourt  2 , Silmar Teixeira  3 , Victor Hugo Bastos  3
Affiliations

Palm to Finger Ulnar Sensory Nerve Conduction

Eduardo Davidowich et al. Neurol Int. .

Abstract

Ulnar neuropathy at the wrist (UNW) is rare, and always challenging to localize. To increase the sensitivity and specificity of the diagnosis of UNW many authors advocate the stimulation of the ulnar nerve (UN) in the segment of the wrist and palm. The focus of this paper is to present a modified and simplified technique of sensory nerve conduction (SNC) of the UN in the wrist and palm segments and demonstrate the validity of this technique in the study of five cases of type III UNW. The SNC of UN was performed antidromically with fifth finger ring recording electrodes. The UN was stimulated 14 cm proximal to the active electrode (the standard way) and 7 cm proximal to the active electrode. The normal data from amplitude and conduction velocity (CV) ratios between the palm to finger and wrist to finger segments were obtained. Normal amplitude ratio was 1.4 to 0.76. Normal CV ratio was 0.8 to 1.23.We found evidences of abnormal SNAP amplitude ratio or substantial slowing of UN sensory fibers across the wrist in 5 of the 5 patients with electrophysiological-definite type III UNW.

Keywords: Ulnar nerve; nerve conduction; neuropathy; wrist.

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Conflict of interest statement

Conflict of interest: the authors declare no potential conflict of interest.

Figures

Figure 1.
Figure 1.
Electrode montage for wrist to finger and palm to finger ulnar sensory nerve conduction. S1: Wrist stimulus point; P: Pisiform bone; S2: Palm stimulus point; G1: Active recorder electrode; G2: Reference recorder electrode.
Figure 2.
Figure 2.
Traces from patient 1 right ulnar sensory nerve conduction. Upper trace: 14 cm wrist to fifth finger, present with prolonged latency and reduced amplitude (3.76 ms/7.7 µV). Second trace: 7 cm palm to finger normal SNAP (1.91 ms/15.7 µV). Third trace: intentionally without waves. Fourth trace: normal DBUN (2.23 ms/12.1 µV).
See this image and copyright information in PMC

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