STUDY OF UPPER LIMB PERIPHERAL NERVE PATHOLOGIES WITH SPECIAL EMPHASIS ON QUICK DASH SCORE AND SELECTED ELECTROMYOGRAPHIC PARAMETERS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 4
Abstract
BACKGROUND Clinical disability or inability to use full function of upper limb and EMG can be a guide to assess probability of severity of pathological damage. Pathologies like neuropraxia, axonotmesis and neurotmesis have varied disability presentation and EMG findings. Hence, disability scores and EMG can correlate well with peripheral nerve pathologies. The purpose of this study is evaluation of peripheral nerve pathologies using disability score and electromyographic (EMG) findings. MATERIALS AND METHODS Study design was hospital-based cross-sectional study, which was conducted in outpatient medical and surgical department of MY Hospital, Indore, in patients of upper limb peripheral nerve pathologies with intention of identifying the selected epidemiological variables along with measurement of quick DASH (Disabilities of the Arm, Shoulder and Hand score) and analysing the electromyographic findings. Study was conducted over a period of one year from January 2015 to December 2015. RESULTS There were 51 patients (mean age 36; SD, 11.7 years) with peripheral nerve pathologies (n= 39) and traumatic injuries (n= 12). Female-to-male ratio was 2.18: 1. Mean quick DASH score was 61.35 (SD, 20.5) of 100. For traumatic patients mean quick DASH score was 83.25 (SD, 13.13) and for non-traumatic patients it was 57.41 (SD, 14.65). Electromyographic parameter of voluntary muscle activity and recruitment were absent in all of the twelve traumatic injury patients and it was present in other thirty-nine non-traumatic neuropathies. Electromyographic finding of spontaneous potential was observed in all the 51 patients. CONCLUSION High quick DASH scores are found in traumatic injury patients. In non-traumatic neuropathies, the quick DASH scores are quite disabling but not that high. Electromyographic findings in traumatic injuries are suggestive of neurotmesis. Finding of spontaneous activity in all the patients suggest active denervation (axonotmesis or neurotmesis) and it warrants aggressive treatment.
Authors and Affiliations
Archana Verma, Sachin Verma, Sonia Moses, Rajkumar Mathur, Lukesh Patil5, Siddharth Saraf, Abhishek Verma, Sharad Gova
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