JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v4i2.2327 jpsim.v4i2.2327 Original Research Frequency of Ulnar Neuropathy, Etiologies and Electro-Diagnostic Correlation with Clinical Severity Batool Masooma Bano Safia safiabano207@gmail.com * Shamim Faryal Numan Ahsan King Edward Medical University/ Mayo Hospital Lahore *Correspondence: Safia Bano (safiabano207@gmail.com) 02 06 2023 2023 4 2 130 134 14 02 2023 08 03 2023 Copyright © 2023 The Author(s) 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

To determine frequency of ulnar neuropathy, etiology. Electro-diagnostic correlation with clinical severity.

 Methodology

This cross-sectional study was conducted in Neurology, King Edward Medical University Lahore. 95 patients, clinically diagnosed with ulnar neuropathy, were included, from July 2022 to Dec 2022. Patients with polyneuropathy, radiculopathy and plexopathy were excluded from study. Nerve conduction studies were performed by conventional methods. Electro-diagnostic findings were noted in predesigned proforma along with history and demographic variables.

 Results

Out of total 95 patients, 72 patients were male and 23 were females. Most prevalent age group was 15–30 years old (mean age 32.0 + 12.7 years). 86.3% of the cases (64 males and 18 females) were traumatic (52 at the elbow, 26 at forearm, 04 at wrist). Trauma was more than entrapment or any other etiology. Frequent site of injury was elbow (58.9%) of all cases. A moderate positive correlation was noted between EDX and clinical severity. (r = 0.58)

 Conclusion

Ulnar neuropathy is commonly seen at elbow after this forearm, wrist with high rate of traumatic nerve injuries. Young population was affected with male predominance. A detail clinical evaluation along with electro-diagnostics is valuable to determine the ulnar neuropathic pattern and its localization. Clinical and electro-diagnostic severity correlation is valuable in predicting prognosis.

 Keywords Ulnar neuropathy Electro-diagnostics Intramuscular non-traumatic injury References Lo YL, Ratnagopal P, Leoh TH, Dan YF, Lee MP, Yong FC. Clinical and electrophysiological aspects of distal ulnar neuropathy. Acta Neurol Scand 2002;105(2):390-4. Pelosi, Luciana; Tse, Dominic Ming Yin; Mulroy, Eoin; Chancellor, Andrew M.; Boland, Michael R. Ulnar neuropathy with abnormal non-localizing electrophysiology: Clinical, electrophysiological and ultrasound findings. Clinical Neurophysiology,2018; 129(10), 2155-61. Mondelli M, Giannini F, Ballerini M, Ginanneschi F, Martorelli E. Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy). J Neurol Sci. 2005;234(1-2):5-10. Raeissadat SA, Youseffam P, Bagherzadeh L, Rayegani SM, Bahrami MH, Eliaspour D. Electrodiagnostic Findings in 441 Patients with Ulnar Neuropathy-aRetrospectiveStudy. OrthopResRev.2019;11(1):191-98. Pelosi L, Tse DMY, Mulroy E, Chancellor AM, Boland MR. Ulnar neuropathy with abnormal non-localizing electrophysiology: Clinical, electrophysiological and ultrasound findings. Clin Neurophysiol. 2018;129(10):2155-61. Eliaspour D, Sedighipour L, Hedayati-Moghaddam MR, Rayegani SM, Bahrami MH, Roghani RS. The pattern of muscle involvement in ulnar neuropathy at the elbow. Neurol India. 2012;60(1):36. Kimura I, Avyar RD, Lippman SM. Early electrodiagnosis of the ulnar entrapment neuropathy at the elbow. Tohoku J Exp Med 1984;142(1):165-72. Omejec G, Podnar S. Proposal for electrodiagnostic evaluation of patients with suspected ulnar neuropathy at the elbow. Clinical Neurophysiology. 2016;127(4):1961-7. Kouyoumdjian JA, Graça CR, Ferreira VFM. Peripheral nerve injuries: A retrospective survey of 1124 cases. Neurol India. 2017;65(3):551-5. Eser F, Aktekin LA, Bodur H, Atan C (2009) Etiological factors of traumatic peripheral nerve injuries. Neurol India. 2009;57(4):434-7. Mondelli M, Giannini F, Ballerini M, Ginanneschi F, Martorelli E. Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy). J Neurol Sci. 2005;234(1-2):5-10. Yadav, R.L. A retrospective study of electrodiagnostically evaluated ulnar neuropathies with special guidelines for ulnar neuropathies at elbow. Beni-Suef Univ J Basic Appl Sci 2022;11(1):31. Dumitru D, Zwarts M. Focal peripheral neuropathies. In: Dumitru D, Amato A, Zwarts’ M, editors. Electrodiagnostic Medicine. Philadelphia: Hanley and Belfus Inc; 2002. p. 1043-1126. Benecke R, Conrad B. The value of electrophysiological examination of the flexor carpi ulnaris muscle in the diagnosis of ulnar nerve lesion at the elbow. J Neurol. 1980;223(1):207-17. Preston DC, Barbara Shapiro Comte. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. London: Elsevier Saunders; 2013. Rayegani S M, Nouri F, Benam M. Prevalence and Causes of Ulnar Neuropathy in the Electrodiagnosis Clinic of Shohadae-Tajrish Medical Center. Mens Health J. 2021; 5(1): e36. Kim HJ, Park SK, Park SH. Upper limb nerve injuries caused by intramuscular injection or routine venipuncture. Anesth Pain Med. 2017;12(2):103-10. Duggal A, Anastakis DJ, Salonen D, Becker E. Compression of the deep palmar branch of the ulnar nerve by a ganglion : a case report. Hand (N Y). 2006;1(2):98-101. Kim MJ, Kang JW, Kim GY, Lim SG, Kim KH, Park BK, Kim DH. Diagnosis of pure ulnar sensory neuropathy around the hypothenar area using orthodromic inching sensory nerve conduction study: a case report. Anna Rehabil Med. 2018;42(3):483-7. Dy CJ, Mackinnon SE. Ulnar neuropathy: evaluation and management. Curr Rev Musculoskelet Med. 2016;9(2):178-84. Calfee RP, Manske PR, Gelberman RH, Van Steyn MO, Steffen J, Goldfarb CA. Clinical assessment of the ulnar nerve at the elbow: reliability of instability testing and the association of hypermobility with clinical symptoms. J Bone Joint Surg Am 2010;92(17):2801-8.