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Variability in electrodiagnostic findings associated with neurogenic thoracic outlet syndrome.
Mul, Karlien; Pesser, Niels; Vervaart, Kimberly; Teijink, Joep; van Nuenen, Bart; van Alfen, Nens.
Afiliación
  • Mul K; Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Pesser N; Department of Vascular surgery, Catharina Hospital, Eindhoven, The Netherlands.
  • Vervaart K; CAPHRI-Research Center, Maastricht University, Maastricht, The Netherlands.
  • Teijink J; Department of Neurology, Catharina Hospital, Eindhoven, The Netherlands.
  • van Nuenen B; Department of Vascular surgery, Catharina Hospital, Eindhoven, The Netherlands.
  • van Alfen N; CAPHRI-Research Center, Maastricht University, Maastricht, The Netherlands.
Muscle Nerve ; 65(1): 34-42, 2022 01.
Article en En | MEDLINE | ID: mdl-34378193
INTRODUCTION/AIMS: Neurogenic thoracic outlet syndrome (NTOS) is a heterogeneous and often disputed entity. An electrodiagnostic pattern of T1 > C8 axon involvement is considered characteristic for the diagnosis of NTOS. However, since the advent of high-resolution nerve ultrasound (US) imaging, we have encountered several patients with a proven entrapment of the lower brachial plexus who showed a different, variable electrodiagnostic pattern. METHODS: In this retrospective case series, 14 patients with an NTOS diagnosis with a verified source of compression of the lower brachial plexus and abnormal findings on their electrodiagnostic testing were included. Their medical records were reviewed to obtain clinical, imaging, and electrodiagnostic data. RESULTS: Seven patients showed results consistent with the "classic" T1 axon > C8 pattern of involvement. Less typical findings included equally severe involvement of T1 and C8 axons, more severe C8 involvement, pure motor abnormalities, neurogenic changes on needle electromyography in the flexor carpi radialis and biceps brachii muscles, and one patient with an abnormal sensory nerve action potential (SNAP) amplitude for the median sensory response recorded from the third digit. Patients with atypical findings on electrodiagnostic testing underwent nerve imaging more often compared to patients with classic findings (seven of seven patients vs. five of seven respectively), especially nerve ultrasound. DISCUSSION: When there is a clinical suspicion of NTOS, an electrodiagnostic finding other than the classic T1 > C8 pattern of involvement does not rule out the diagnosis. High resolution nerve imaging is valuable to diagnose additional patients with this treatable condition.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Desfiladero Torácico / Electromiografía Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Muscle Nerve Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Desfiladero Torácico / Electromiografía Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Muscle Nerve Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos