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Demuth S, Courtois S, Cohen E, Goudot M. Acute dysautonomia and erythromelalgia associated with testicular seminoma: A case report. Rev Neurol (Paris) 2020; 177:146-147. [PMID: 32631673 DOI: 10.1016/j.neurol.2020.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 11/26/2022]
Affiliation(s)
- S Demuth
- Service de Neurologie, groupe hospitalier de la région sud Alsace, 20 Avenue du Dr René Laennec, 68100 Mulhouse, France.
| | - S Courtois
- Service de Neurologie, groupe hospitalier de la région sud Alsace, 20 Avenue du Dr René Laennec, 68100 Mulhouse, France.
| | - E Cohen
- Service de Neurologie, groupe hospitalier de la région sud Alsace, 20 Avenue du Dr René Laennec, 68100 Mulhouse, France.
| | - M Goudot
- Service de Neurologie, groupe hospitalier de la région sud Alsace, 20 Avenue du Dr René Laennec, 68100 Mulhouse, France.
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Di Virgilio G, Grapperon AM, Fayerstein J, Goudot M, Nollet S, Ochsner F, Théaudin M, Truffert A, Tsouni P, Vial C, Wang FC, Pasquier J, Tatu L, Attarian S, Kuntzer T. Ulnar neuropathy at the elbow: Reappraisal of the wrist-upper arm latency difference between ulnar and median nerves. Clin Neurophysiol 2019; 131:372-376. [PMID: 31865138 DOI: 10.1016/j.clinph.2019.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the sensitivity and specificity of the latency difference (DLat) between ulnar and median nerves of the arm after stimulation at the wrist; one of the easiest techniques proposed for recognizing ulnar neuropathy at the elbow (UNE). As latency difference is not a standardized technique, we set up a multicenter study to recruit large numbers of normal subjects and patients with UNE or generalized neuropathy. METHODS Six centers participated in the study with data obtained from three groups of participants, controls (CTRLs), patients with UNE and patients with generalized neuropathy (GNP). We first verified the anatomical superposition of the ulnar and median nerves in cadaver examination. The optimal recording site for these two nerves was found to be 10 cm above the medial epicondyle. We then standardized the position of the arm with full extension of the elbow and stimulated first the median and then the ulnar nerves at the wrist. CTRLs were examined on both arms at two consecutive visits. RESULTS We recorded 32 idiopathic UNE cases, 44 GNP patients and 62 controls. We demonstrated that a DLat cut-off value of 0.69 ms brings a sensitivity of 0.86 and specificity of 0.89 to discriminate CTRLs from UNE. We also validated that intra-examiner reproducibility was good. CONCLUSION We report a lower normal value for DLat than reported in several non-standardized studies and CTRL and UNE groups have clearly separated DLat values. SIGNIFICANCE Due to its high sensitivity, our standardized technique could be used as a first-line diagnostic tool when UNE is suspected.
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Affiliation(s)
- G Di Virgilio
- Unité Nerf-Muscle, Service de Neurologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - A M Grapperon
- Reference Center for Neuromuscular Disorders and ALS, CHU La Timone, Aix-Marseille University, Marseille, France
| | - J Fayerstein
- Reference Center for Neuromuscular Disorders and ALS, CHU La Timone, Aix-Marseille University, Marseille, France
| | - M Goudot
- Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - S Nollet
- Service de Neurologie-Électrophysiologie clinique, University Hospital (CHRU), Besançon, France
| | - F Ochsner
- Unité Nerf-Muscle, Service de Neurologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - M Théaudin
- Unité Nerf-Muscle, Service de Neurologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - A Truffert
- Unité de Neuroimmunologie et des maladies Neuromusculaires, Hôpitaux Universitaires de Genève (HUG), Switzerland
| | - P Tsouni
- Unité Nerf-Muscle, Service de Neurologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Unité de Neuroimmunologie et des maladies Neuromusculaires, Hôpitaux Universitaires de Genève (HUG), Switzerland
| | - C Vial
- Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - F C Wang
- Neurophysiology Department, CHU Sart Tilman, Liège, Belgium
| | - J Pasquier
- Département Formation, Recherche et Innovation, Centre universitaire de médecine générale et santé publique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - L Tatu
- Service de Neurologie-Électrophysiologie clinique, University Hospital (CHRU), Besançon, France
| | - S Attarian
- Reference Center for Neuromuscular Disorders and ALS, CHU La Timone, Aix-Marseille University, Marseille, France
| | - T Kuntzer
- Unité Nerf-Muscle, Service de Neurologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
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