Electrophysciological Analysis of Entrapment Neuropathies Developed in Acute and Subacute Period in Paretic and Non-Paretic Extremities in Patients With Stroke

Abstract

Objective: To investigate entrapment neuropathies in stroke patients in a hospital in Turkey with Medical Research Council (MRC) score <= 2/5 and in those with MRC score >= 3/5. Methods: The study comprising 40 patients from January 2008 to June 2009 in the Stroke Unit of the Department of Neurology, Yuzuncu Yil University in Van, Turkey, entailed electrophysiological analysis of median, ulnar, radial nerves, peroneal, tibial and sural nerves in paretic and nonparetic upper and lower extremities. National Institute of Health Stroke scale was used for the evaluation of neurological deficient, while nerve conduction studies were performed for the diagnosis of entrapment neuropathies (EN). The patients were divided into two groups based on their initial Medical Research Council (MRC) score: < 2/5 and > 3/5. Both groups had 20 patients each. The readings were compared in the control phase 45 to 50 days after the stroke. Paired samples test and t-test using SPSS version 15 were used for statistical analysis. Results: Carpal tunnel syndrome (CTS) at wrist was found in 7 (35%) patients, cubital tunnel syndrome at elbow in 3 (15%) patients, and evident reduction in motor action potential values of peroneal, median and ulnar nerve in 10 (50%) patients in the control studies for conduction on our patients with Medical Research Council (MRC) score of <= 2/5, unlike the initial findings, in the paretic side. Among the patients, in the other group, 2 (10%) developed bilateral Camel tunnel syndrome, and it was also detected in the healthy upper extremities in 2 (10%) more patients. In the control studies for conduction in patients with Medical Research Council score of >= 3/5, Camel tunnel syndrome was detected in the healthy side in 4 (20%) patients and in the affected side in 3 (15%) patients. Conclusion: In patients with severe paresis, if the affected extremity is not functional, symptoms of entrapment neuropathy are easy to occur.