GEHS neurophysiological classification system for patients with neuropathy of the ulnar nerve at the elbow.

Abstract

Background: Neuropathy of the ulnar nerve at the elbow is one of a number of muscle-related and nerve-related disorders that affect people performing intensive work with their hands and upper extremities, and is the second most prevalent peripheral nerve mononeuropathy. There are several classification systems currently being used by the medical community for patients with neuropathy of the ulnar nerve at the elbow. However, few of these classification systems include the clinical electrophysiologic parameters nerve conduction (NCS) and electromyographic (EMG) studies.

Purpose: This article describes the GEHS (Greathouse, Ernst, Halle, and Shaffer) neurophysiological classification system for patients with neuropathy of the ulnar nerve at the elbow and includes 2 case studies of patients with electrophysiological evidence of neuropathy of the ulnar nerve at the elbow.

Case studies: Two case studies of patients with electrophysiological evidence of neuropathy of the ulnar nerve at the elbow are presented. The GEHS neurophysiological classification system is incorporated into the discussion of these case studies.

Summary and clinical relevance: This article describes the GEHS neurophysiological classification system for patients with neuropathy of the ulnar nerve at the elbow which incorporates findings for both the NCS and EMG components of the electrophysiological examination. Availability of expanded electrophysiological data that includes both NCS and EMG testing provides the healthcare team and the patient with more detailed information that may be useful in determining next treatment steps as well as long-term prognosis. Future research comparing the psychometric properties and prognostic utility of the GEHS neurophysiologic classifications is warranted.