Median and Ulnar Nerve Conduction Studies in Young Adult Violinists

2000 ◽  
Vol 15 (3) ◽  
pp. 123-128
Author(s):  
Elizabeth A Bowie ◽  
Kristen M Brimer ◽  
Melissa S Kidder ◽  
Monica L Wallis ◽  
Nancy S Darr ◽  
...  
Keyword(s):  
Young Adult ◽  
Upper Extremity ◽  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Normal Values ◽  
Motor Nerve ◽  
Nerve Conduction Studies ◽  
Upper Extremities ◽  
Physical Examinations ◽  
Median Neuropathy

The incidence of musculoskeletal injuries among musicians is well documented. The purpose of this study was to describe the neural status of the median and ulnar nerves in young adult violinists. Twenty volunteer violinists were recruited from the Belmont University and the Vanderbilt University Blair School of Music Orchestras (age 18-30 years). The subjects completed a history form and underwent a physical examination. The electrophysiologic status of the median and ulnar nerves in both upper extremities was then evaluated using sensory and motor nerve conduction studies (NCSs). Upon completion of the NCSs, educational materials to prevent upper extremity cumulative trauma disorders were distributed to the subjects. In these subjects, the history and subjective examination were largely noncontributory of upper extremity neuropathies. Their physical examinations were also not diagnostic of upper extremity neuropathies. All subjects’ median and ulnar NCSs were normal when compared with a chart of normal values. However, when comparison studies between the median and ulnar NCSs in the same extremity were performed, seven subjects showed differences in their distal motor latencies (>1.0 msec) or distal sensory latencies (>0.5 msec) that could be suggestive of early median neuropathy at or distal to the wrist. In this descriptive study, 20 young adult violinists had no subjective findings of median or ulnar neuropathy, had normal physical examinations of the neck and both upper extremities, and had normal median and ulnar NCSs when compared with a chart of normal values. However, when comparison NCSs between the median and ulnar nerve in the same extremity were performed, seven violinists were found to have NCS values suggestive of early median neuropathy at or distal to the wrist. In this population of 20 young adult violinists, seven musicians were found to have electrophysiologic findings suggestive of early median neuropathy at or distal to the wrist.

Median and Ulnar Neuropathies in University Cellists

2005 ◽  
Vol 20 (2) ◽  
pp. 70-76
Author(s):  
Ellie Jo Logue ◽  
Susana Bluhm ◽  
Mary Clayton Johnson ◽  
Rayna Mazer ◽  
John S Halle ◽  
...  
Keyword(s):  
Physical Examination ◽  
Upper Extremity ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Upper Extremities ◽  
School Of Music ◽  
Entrapment Neuropathies ◽  
Extensive Evaluation ◽  
Upper Extremity Injury ◽  
Musculoskeletal Function

Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Bowed string players are at risk for entrapment neuropathies in the upper extremities and are sensitive to mild neurologic deficits. The purpose of this study was to determine the presence of median and ulnar neuropathies in both upper extremities of university cellists. Fourteen volunteer cellists (ages 18-32 yrs) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music orchestras. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing sensory, motor, and F-wave nerve conduction studies. After completion of the median and ulnar nerve conduction studies, the cellists were instructed in upper extremity injury prevention exercises. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. These subjects had normal upper extremity neural and musculoskeletal function based on extensive evaluation, including a history, physical examination, and nerve conduction studies. There was no evidence of median or ulnar neuropathy at or distal to the wrist, in the forearm, across the elbow, or in the arm of the tested subjects.

scholarly journals Determining the utility of minimum F-wave latency alterations in the electrodiagnosis of ulnar neuropathy at the elbow

2021 ◽  
Vol 79 (3) ◽  
pp. 195-200
Author(s):  
Abdulkadir TUNÇ ◽  
Vildan GÜZEL ◽  
Aysel TEKEŞİN ◽  
Yıldızhan ŞENGÜL
Keyword(s):  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Motor Nerve ◽  
Treatment Options ◽  
Diagnostic Value ◽  
Upper Extremities ◽  
Ulnar Neuropathy ◽  
F Wave ◽  
The Mean ◽  
Wave Latency

ABSTRACT Background: Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy. There is little information about the application of F-wave studies for evaluation of UNE. Objective: The aim of this study was to evaluate the diagnostic value of minimum F-wave (F-min) latency alterations by comparing this with nerve conduction analyses in UNE-suspected patients. Methods: Ninety-four UNE-suspected patients were admitted to this study. Sensory and motor nerve conduction and F-wave analyses on the median and ulnar nerves were performed on both upper extremities. Results: A total of 188 upper extremities of 94 patients were examined. Their mean age was 41.4±12.9 years, and 69 patients were female (73.4%). The mean ulnar-nerve across-elbow motor conduction velocity (MCV) in the affected arms was significantly slower than the velocity in healthy arms. The mean ulnar-nerve F-min latencies were significantly longer in the affected arms. Fifty-one patients were electrophysiologically diagnosed as presenting UNE (54.2%). Significantly slower mean ulnar-nerve across-elbow MCV, longer mean ulnar-nerve F-min latency and longer distal onset latency were detected in UNE-positive arms. Lastly, patients who were symptomatic but had normal nerve conduction were evaluated separately. Only the mean ulnar F-min latency was significantly longer in this group, compared with the healthy arms. Conclusion: Our study confirmed the utility of F-min latency measurements in the electrodiagnosis of UNE. F-wave latency differences can help in making an early diagnosis to provide better treatment options.

scholarly journals Ulnar Nerve Enlargement at the Medial Epicondyle Negatively Correlates With Nerve Conduction Velocity in Cubital Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 165-169
Author(s):  
T. David Luo ◽  
Amy P. Trammell ◽  
Luke P. Hedrick ◽  
Ethan R. Wiesler ◽  
Francis O. Walker ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Motor Nerve ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Motor Nerve Conduction ◽  
Nerve Enlargement ◽  
Tunnel Syndrome

Background: In cubital tunnel syndrome (CuTS), chronic compression often occurs at the origin of the flexor carpi ulnaris at the medial epicondyle. Motor nerve conduction velocity (NCV) across the elbow is assessed preoperatively to corroborate the clinical impression of CuTS. The purpose of this study was to correlate preoperative NCV to the direct measurements of ulnar nerve size about the elbow at the time of surgery in patients with clinical and/or electrodiagnostic evidence of CuTS. Methods: Data from 51 consecutive patients who underwent cubital tunnel release over a 2-year period were reviewed. Intraoperative measurements of the decompressed nerve were taken at 3 locations: at 4 cm proximal to the medial epicondyle, at the medial epicondyle, and at the distal aspect of Osborne fascia at the flexor aponeurotic origin. Correlation analysis was performed comparing nerve size measurements to slowing of ulnar motor nerve conduction velocities (NCV) below the normal threshold of 49 m/s across the elbow. Results: Enlargement of the ulnar nerve at the medial epicondyle and nerve compression at the flexor aponeurotic origin was a consistent finding. The mean calculated cross-sectional area of the ulnar nerve was 0.21 cm2 above the medial epicondyle, 0.30 cm2 at the medial epicondyle, and 0.20 cm2 at the flexor aponeurotic origin ( P < .001). There was an inverse correlation between change in nerve diameter and NCV slowing ( r = −0.529, P < .001). Conclusions: For patients with significantly reduced preoperative NCV and clinical findings of advanced ulnar neuropathy, surgeons can expect nerve enlargement, all of which may affect their surgical decision-making.

Comparison of Borderline Ultrasound and Nerve Conduction Studies for Carpal Tunnel Syndrome

Hand ◽  
2020 ◽  
pp. 155894472096496
Author(s):  
Cory Demino ◽  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Threshold Values ◽  
Cutoff Values ◽  
Number Of Patients ◽  
Tunnel Syndrome ◽  
Median Neuropathy

Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

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