Dorsal ulnar cutaneous nerve conduction: reference values

Abstract

-We investigated the reference values of the dorsal ulnar cutaneous nerve (DUC) sensory nerve conduction (SNC) in 66 healthy individuals. Measurements were processed using stimulating electrodes positioned between the ulnar bone and the flexor carpi ulnaris muscle, 11-13 cm proximal to the active electrode recording. Superficial recording electrodes were placed on the fourth intermetacarpal space. The mean sensory conduction velocity (SCV) in males was 63.7 -0.16 x age ± 3.36 m/s and in females was 57.7 ± 3.37 m/s. The mean sensory nerve action potential (SNAP) amplitude in males was 19.5 ± 10.7 µV and in females was 24.6 ± 5.8 µV. The mean SNAP duration was 0.96 ± 0.13 ms. No significant differences regarding the DUC-SCV, distal latency, and SNAP duration or amplitude were found between both sides of the same subject. The amplitude of the SNAP was higher in females than males. The effects of age on DUC-SCV were distinct for each gender.KEY WORDS: dorsal ulnar cutaneous nerve, nerve conduction, reference values, age, height, sex, temperature.Condução nervosa do nervo cutâneo ulnar dorsal: valores de referência Condução nervosa do nervo cutâneo ulnar dorsal: valores de referência Condução nervosa do nervo cutâneo ulnar dorsal: valores de referência Condução nervosa do nervo cutâneo ulnar dorsal: valores de referência Condução nervosa do nervo cutâneo ulnar dorsal: valores de referência RESUMO -Investigamos os valores de referência da condução nervosa sensitiva do nervo cutâneo ulnar dorsal em 66 indivíduos normais, por técnica de condução nervosa antidrômica. A velocidade de condução sensitiva (VCS) média, em homens foi 63,7 -0,16 x idade ± 3,36 m/s e nas mulheres 57,7 ± 3,37 m/s. A amplitude média do potencial de ação nervoso sensitivo (PANS) em homens foi 19,5 ± 10,7 µV e nas mulheres foi 24,6 ± 5,8 µV. A duração média do PANS foi 0,96 ± 0,13 ms. A dominância manual não interferiu nos valores da VCS, latência distal, amplitude e duração do PANS. Nas mulheres a amplitude do PANS foi maior do que nos homens. Os efeitos da idade na VCS foram distintos para cada sexo. PALAVRAS-CHAVE: nervo cutâneo ulnar dorsal, condução nervosa, valores de referência, altura, idade, sexo, temperatura.The dorsal ulnar cutaneous nerve (DUC), a branch of the ulnar nerve, leaves the main ulnar trunk approximately at the junction of the medial and distal thirds of the forearm 1 , then it takes a dorsal position at the wrist and continues on the dorsomedial region of the hand 2 . The purposes of studying the DUC sensory nerve conduction (SNC) include distinction between proximal and distal ulnar nerve lesions 3-5 , identification of isolated lesions of this nerve branch 5,6 , and investigation of the dorsomedial hand innervation 6,7 .The DUC is vulnerable to laceration, blunt trauma, and compression injury due to its superficial position 8 . In addition, determination of the DUC-SNC is helpful to confirm or rule out proximal lesions of the ulnar nerve. Lesions of the ulnar nerve at the level of the elbow and wrist are highly fre...

Neurophysiological study of the radial nerve variant in the innervation of the dorsomedial surface of the hand

“…Our study provides evidence of a significant percentage of individuals whose dorsomedial portion of the hand is innervated by the SRN as a normal variant. The values we obtained in nerve conduction of the DUN in the limbs with usual innervation were similar to those reported by others using a similar technique . Among the 716 hands that were studied, only 1 showed no SRN or DUN response.…”

“…The values we obtained in nerve conduction of the DUN in the limbs with usual innervation were similar to those reported by others using a similar technique. [8][9][10]21,[25][26][27][28] Among the 716 hands that were studied, only 1 showed no SRN or DUN response. This case was possibly caused by a subclinical injury or is another normal variant.…”

“…A normal variant has been described in which the superficial radial nerve (SRN) rather than the dorsal ulnar nerve (DUN) innervates the dorsomedial portion of the hand [1][2][3][4][5][6][7][8][9][10][11][12][13][14] or in which innervation by both nerves occurs simultaneously [2][3][4][5]15,16 ; however, few articles have been published on this topic, and the reported frequency differs. 15,[17][18][19][20][21][22][23][24] Nerve conduction of the DUN was described by Jabre 25 in 1980; since then, various authors [8][9][10]21,[26][27][28] have described small variations to this technique. Because of its anatomical course (emerging from the ulnar trunk, usually in the distal third of the forearm), some authors advocate studying nerve conduction when localizing lesions of the ulnar nerve.…”

“…Nerve conduction of the DUN was described by Jabre in 1980; since then, various authors have described small variations to this technique. Because of its anatomical course (emerging from the ulnar trunk, usually in the distal third of the forearm), some authors advocate studying nerve conduction when localizing lesions of the ulnar nerve .…”

<p>Electrodiagnostic Findings in 441 Patients with Ulnar Neuropathy - a Retrospective Study</p>

“…To obtain the response, a surface electrode is placed on the proximal phalanx of the fifth digit as an active electrode and the reference electrode is fixed 4 cm distally. Wrist stimulation is performed 14 cm proximal to the active electrode, near the tendon of the flexor carpi ulnaris at the wrist 20. Dorsal ulnar cutaneous nerve (DUCN) SNAP is measured by placing the active electrode along the dorsum of the fifth metacarpal bone and the reference 4 cm distal.…”