桡神经损伤的临床特征、危险因素及电生理特征

Arfah Kanwal, Safia Bano, Ubaid Ullah, Ahsan Numan
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摘要

背景与目的:桡神经损伤是由多种原因引起的。本研究的目的是确定临床谱,危险因素和电生理方面的桡神经损伤呈现在拉合尔三级护理医院。方法:这项描述性前瞻性横断面研究于2022年7月至2022年12月在拉合尔梅奥医院神经内科进行,根据病史和临床检查纳入孤立性桡神经损伤患者,不分性别,年龄在15岁以上。NCS/EMG由专家按照疑似桡神经损伤的电诊断评估推荐方案在日本机器Nihon Kohden上完成,并由神经科顾问医生解释。结果:75例患者中,男性52例(69.3%),女性23例(30.7%)。在45%(60%)的患者中,最常见的病因是错位的肌肉注射。36例(40%)患者病变部位位于螺旋槽内。71例(94.7%)患者腕部下垂。30例(40%)患者存在神经再生的证据。结论:桡神经损伤多表现为手腕下垂,最常见的病因是肌内注射错位。多数病例病变部位位于螺旋槽水平,病变性质以轴突丢失为主,继发性脱髓鞘。
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Clinical spectrum, risk factors and electrophysiologic aspect of radial nerve injury
Background and objective: Radial nerve is injured due to a variety of reasons. The objective of this study was to determine the clinical spectrum, risk factors and electrophysiologic aspect of radial nerve injury presenting to a tertiary care hospital in Lahore. Methods: This descriptive prospective cross-sectional study was conducted at department of Neurology, Mayo hospital Lahore from July 2022 to December 2022 and comprised patients with isolated radial nerve injury on the basis of history and clinical examination regardless of their gender, above 15 years of age. NCS/EMG was done on a Japanese machine Nihon Kohden by an expert as per recommended protocol for electrodiagnostic evaluation of a suspected radial nerve injury and interpreted by consultant neurologist. Results: Of 75 patients, 52(69.3%) were males and 23(30.7%) were females. The most common etiology turned out to be misplaced intramuscular injection in 45(60%) of the patients. The site of lesion in most cases was in the spiral groove in 36 (40%) of the patient. Most of the patients i.e. 71(94.7%) had a wrist drop. Evidence of reinnervation was present in 30(40%) of patients. Conclusion: Most cases of radial nerve injury presented with a wrist drop in which the commonest etiology was misplaced intramuscular injection. The site of lesion in most cases turned out to at the level of spiral groove, and the nature of lesion was primarily axonal loss followed by secondary demyelination.
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