Ulnar neuropathy at Jordan University Hospital

OBJECTIVE: To study the causes, clinical and electromyography/nerve conduction study (EMG/NCS) findings and treatment modalities in Jordanian patients with ulnar neuropathy (UN) observed in a tertiary care referral center and compare the findings with those from Western literature.

METHODS: The case notes of 20 patients with UN referred to the neurophysiology department at Jordan University Hospital, Amman, Jordan, between January 2002 and January 2004 were reviewed. The clinical presentation, causes, EMG/NCS and treatment modalities were registered.

RESULTS: Among the 20 patients, 18 were male and 2 female with a mean age of 39 years (range 14-68 years). Ten cases were traumatic UN while the other 10 were presumably idiopathic cubital tunnel syndrome (CTS). The most common clinical manifestations were paresthesiae of 4th/5th digits and weakness/atrophy of small hand muscles. All 10 cases of traumatic UN were axonal on EMG/NCS while among the other 10 with CTS, 3 diabetics had axonal injury and 6 out of 7 nondiabetics had a demyelinating injury, 3 sensorimotor and 3 pure sensory. Additional carpal tunnel syndrome was found in 5 patients. Needle EMG was abnormal only in cases of abnormal ulnar sensory action potential. Nine out of 10 with traumatic UN had surgery while only 3 out of 10 with CTS had cubital tunnel release.

CONCLUSION: Compared to previous studies from Western literature, our study shows a similar male predominance as well as comparable clinical and neurophysiological findings and treatment modalities.