The clinical, electrophysiological and prognostic heterogeneity of ulnar neuropathy at the elbow.

Abstract

Ulnar nerve neuropathy is one of the most common entrapment neuropathies and is often considered to be one entity in clinical and follow-up studies. The aim of this study was to determine whether there is a difference in the long term outcome of patients with a severe motor conduction block (mCB) of > or =50% (50% group) in comparison with patients with an mCB of < or =20% (20% group). In a prospective cohort of 244 patients with ulnar neuropathy at the elbow (UNE), 16% had an mCB of > or =50%. These patients were matched with respect to surgery, age and severity of muscle weakness with patients with an mCB of < or =20%. 32 patients per group were evaluated clinically and electrophysiologically. The median follow-up period was 25 months. Based on the patient's assessment, 26 (81%) patients in the 50% group and 14 (44%) patients in the 20% group had a good outcome (p = 0.005). The clinical examination showed a good outcome in 27 (84%) in the 50% group and in 13 (41%) in the 20% group (p = 0.0008). This study showed that the prognosis of patients with focal demyelination of the ulnar nerve presenting with an mCB of > or =50% is more favourable than those without an mCB.