Electrodiagnosis of Lesions of Median and Ulnar Nerve Hand Sensory Branches: A Case Series

Introduction: The authors have recently tested a new electrodiagnostic technique for palmar proper digital nerves sensory nerve action potentials in normal controls. Here the authors explored whether it may offer additional information in comparison to mixed nerve wrist stimulation in a series of patients. Methods: The authors recorded palmar proper digital nerves sensory nerve action potential to selective antidromic webspace stimulation in a group of 19 patients with suspected lesions of median and ulnar nerve hand sensory branches. Coexistent carpal tunnel syndrome was present in 11 patients. Results: The webspace stimulation technique offered additional information in 89% patients when compared with mixed nerve wrist stimulation. Webspace stimulation was informative even when carpal tunnel syndrome coexisted with damage to hand sensory branches and biased the interpretation of conventional wrist nerve conduction study. Conclusions: Webspace PaPDN stimulation is feasible in patients with lesion of median and ulnar nerve hand sensory branches and offer additional information in comparison with wrist-mixed nerve conduction study, also in patients with coexisting carpal tunnel syndrome.