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KMID : 0860920060080020097
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2006 Volume.8 No. 2 p.97 ~ p.103
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The Usefulness and Limitation of the AANEM Guidelines in Electrodiagnosis of Ulnar Neuropathy at the Elbow
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Kim Dae-Hwan
Yi Tae-Im
Kim Joo-Sup
Park Jun-Sung
Lee Jae-Hwan
Koo Hye-Kyung
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Abstract
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Objectives: To examine the usefulness and limitations of the American Association of Neuromuscular & Electrodianostic Medicine (AANEM) guidelines in electrodiagnosis of ulnar neuropathy at the elbow.
Methods: Electrodiagnostic records of 46 arms diagnosed with ulnar neuropathy at the elbow were reviewed retrospectively. We re-evaluated them according to AANEM guidelines.
Results: Among 46 cases, only 31 cases (67.4%) were consistent with AANEM guidelines of ulnar neuropathy at the elbow. Among 4 parameters of AANEM guidelines, parameters related to nerve conduction velocity (NCV) revealed high sensitivities(87.1%, 77.4%). Among other electrodiagnostic parameters, differences with contralateral motor NCV across the elbow(81.8%), small amplitude of ulnar sensory nerve action potential(71.4%), and abnormal electromyographic findings(74.2%) revealed relatively high sensitivities than others. There are significant positive correlations between the numbers of parameters correspondent for AANEM guidelines and the degree of abnormalities of some electrodiagnostic parameters. Most of cases inconsistent with AANEM guidelines revealed the electrodiagnostic findings suggestive of pure axonal injury or sensory nerve fibers involvement.
Conclusion: Despite of the ability to reflect of the disease severity, application of AANEM guidelines can bring about false-negative results. Thus, practitioners should consider to check other sensitive electrodiagnostic parameters together with AANEM guidelines
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KEYWORD
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Elbow, Electrodiagnostic parameters, Sensitivity, Ulnar neuropathy
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