A Arturo Leis1, Keionna J Wells2. 1. Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, Jackson, MS 39216, USA. Electronic address: aleis@mmrcrehab.org. 2. Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, 1350 East Woodrow Wilson, Suite 2, Jackson, MS 39216, USA.
Abstract
OBJECTIVE: To elucidate the clinical and physiologic features of anomalous superficial radial innervation to the ulnar dorsum of hand. METHODS: We performed superficial radial and ulnar dorsal cutaneous nerve conduction studies (NCS) in 100 patients without radial or ulnar neuropathy and in 71 patients with various ulnar neuropathies. RESULTS: Of 100 patients, 16 had anomalous superficial radial innervation to ulnar dorsum of hand. Only 3 subjects had an absent ulnar dorsal cutaneous response without this variant. The anomaly was unilateral in 14 subjects and bilateral in 2, manifesting in 18 of 200 hands (9%). In the 71 patients with various ulnar neuropathies, failure to recognize the variant confounded clinical and NCS diagnoses. CONCLUSIONS: Anomalous superficial radial innervation to the ulnar dorsum of the hand is the most common cause of an absent ulnar dorsal cutaneous response in the population at large. SIGNIFICANCE: It is important to recognize this variant to avoid erroneous diagnoses and inappropriate treatment, and to improve assessment of nerve injury and recovery. From a historical perspective, our findings are the first to adequately explain the degree of asymmetry observed by Jabre [Jabre JF. Ulnar nerve lesions at the wrist: new technique for recording from the sensory dorsal branch of the ulnar nerve. Neurology 1980;30:873-6.] in his seminal paper on the ulnar dorsal cutaneous response.
OBJECTIVE: To elucidate the clinical and physiologic features of anomalous superficial radial innervation to the ulnar dorsum of hand. METHODS: We performed superficial radial and ulnar dorsal cutaneous nerve conduction studies (NCS) in 100 patients without radial or ulnar neuropathy and in 71 patients with various ulnar neuropathies. RESULTS: Of 100 patients, 16 had anomalous superficial radial innervation to ulnar dorsum of hand. Only 3 subjects had an absent ulnar dorsal cutaneous response without this variant. The anomaly was unilateral in 14 subjects and bilateral in 2, manifesting in 18 of 200 hands (9%). In the 71 patients with various ulnar neuropathies, failure to recognize the variant confounded clinical and NCS diagnoses. CONCLUSIONS: Anomalous superficial radial innervation to the ulnar dorsum of the hand is the most common cause of an absent ulnar dorsal cutaneous response in the population at large. SIGNIFICANCE: It is important to recognize this variant to avoid erroneous diagnoses and inappropriate treatment, and to improve assessment of nerve injury and recovery. From a historical perspective, our findings are the first to adequately explain the degree of asymmetry observed by Jabre [Jabre JF. Ulnar nerve lesions at the wrist: new technique for recording from the sensory dorsal branch of the ulnar nerve. Neurology 1980;30:873-6.] in his seminal paper on the ulnar dorsal cutaneous response.
Authors: Konstantinos Natsis; A Giannakopoulou; M Piagkou; N Lazaridis; T Tegos; M R Colonna Journal: Surg Radiol Anat Date: 2017-11-09 Impact factor: 1.246
Authors: Eduardo Davidowich; Osvaldo J M Nascimento; Marco Orsini; Camila Pupe; Bruno Pessoa; Caroline Bittar; Karina Lebeis Pires; Carlos Bruno; Bruno Mattos Coutinho; Olivia Gameiro de Souza; Pedro Ribeiro; Bruna Velasques; Juliana Bittencourt; Silmar Teixeira; Victor Hugo Bastos Journal: Neurol Int Date: 2015-12-29