RESUMO
INTRODUCTION: The aim of this study was to verify the involvement of ulnar nerve fibers in cases of carpal tunnel syndrome (CTS) and investigate the correlation between ulnar nerve conduction parameters and extra-median spread of symptoms. METHODS: Electrophysiological studies were conducted in 93 CTS and 76 control hands. Patients were analyzed with regard to symptoms in the fifth finger. RESULTS: In the CTS cases, ulnar distal motor latency (DML) and distal sensory latency (DSL) were significantly longer, and amplitudes were lower than in controls. Increased median nerve DML correlated with increased ulnar nerve DSL and decreased sensory amplitudes and conduction velocities (SCVs). In cases with symptoms in the fifth finger, ulnar nerve SCVs and amplitudes were lower than in patients without symptoms. CONCLUSIONS: Pathological processes leading to median neuropathy in CTS may affect ulnar nerve motor and sensory fibers in the Guyon canal. This may explain the extra-median spread of sensory symptoms in CTS patients.
Assuntos
Síndrome do Túnel Carpal/fisiopatologia , Condução Nervosa/fisiologia , Nervo Ulnar/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Eletromiografia , Feminino , Dedos/inervação , Humanos , Masculino , Pessoa de Meia-Idade , Neurônios Motores/fisiologia , Células Receptoras Sensoriais/fisiologiaRESUMO
The aim of the study is to determine the temporal course of phrenic nerve palsy in children after cardiac surgery. Prospective electrophysiological measurement of phrenic nerve latencies and diaphragmatic action potential (DAP) amplitudes before and after operation were recorded in 59 children who underwent open heart surgery for congenital heart disease. In patients with phrenic nerve dysfunction, the procedure was repeated at 1 week and 2 weeks after the operation to determine the temporal course. In the early postoperative period, 12 patients had abnormal left phrenic nerve latencies and/or DAP amplitudes, 11 had abnormal right phrenic nerve latencies and/or DAP amplitudes, and 3 had abnormal bilateral phrenic nerve latencies and/or DAP amplitudes. After 2-week follow-up, only one of these patients had persistent left phrenic nerve palsy. Prolonged phrenic nerve latencies and decreased DAP amplitudes often occur in the early postoperative phase in children who undergo cardiac surgery. This palsy is usually transient, and electrophysiologic studies should be repeated at least up to 1 week after surgery before diaphragmatic plication is considered.