ABSTRACT
OBJECTIVE: To explore the pattern of electrodiagnostic findings in cases of wrist drop and compare gender, involved side of the body, and military versus civilian population for the aetiology of wrist drop. METHODS: This cross-sectional study was conducted at Armed Forces Institute of Rehabilitation Medicine Rawalpindi, Pakistan, from August 2013 to December 2014, and comprised wrist drop cases regardless of age or gender. Evaluation was done using XLTEK Neuromax 1004 EMG unit in line with the recommended protocol for electrodiagnostic evaluation of a suspected radial nerve injury(RNI). SPSS 20 was used for data analysis. RESULTS: Of the 119 patients, 97(81.5%) were males, 66(55.5%) were in the 16-30 years' age group, and 96(80.7%) were military personnel. RNI at the mid-arm level was the commonest cause in 88(73.9%) cases. The frequent inciting event was trauma with fracture of the humerus in 39(32.8%) cases. Eighty-four (70.6%) lesions were axonal. Ninety-four (79%) individuals had no associated injury to other nerves. Injuries due to trauma were more frequent in males (p<0.001), on the right side (p=0.046), and in the military population (p=0.05). CONCLUSIONS: RNI at the mid arm level was the commonest cause of wrist drop in our sample and fracture of the humerus was the main inciting event..
Subject(s)
Fractures, Bone/complications , Humerus/injuries , Iatrogenic Disease , Peripheral Nerve Injuries/etiology , Radial Nerve/injuries , Radial Neuropathy/etiology , Adolescent , Adult , Electrodiagnosis , Electromyography , Female , Hospitals, Military , Humans , Male , Median Nerve/injuries , Middle Aged , Military Personnel/statistics & numerical data , Neural Conduction , Peripheral Nerve Injuries/diagnosis , Radial Neuropathy/diagnosis , Spinal Nerve Roots/injuries , Ulnar Nerve/injuries , Young AdultABSTRACT
Progressive muscle atrophy is a rare subtype of motor neuron disease that affects only the lower motor neurons and presents as asymmetrical rapidly progressive muscle weakness, atrophy and normal sensations. The diagnostic electrophysiological findings are denervation potentials in three out of four body segments (bulbar, cervical, thoracic and lumbosacral). The disease is fatal and the management is supportive. We present the report of a 45-year-old female patient who presented with unilateral foot drop and rapidly progressed to profound weakness in muscles of all limbs, neck and back along with dysarthria and dysphagia. She had been operated twice for suspected cervical and lumbosacral intervertebral disc herniations and ultimately guided in right direction after muscle biopsy, nerve conduction studies and electromyography.
