Clinical and Electrodiagnostic Work-up of Peripheral Nerve Lesions

  • Stefan Kiechl
Part of the Medical Radiology book series (MEDRAD)


Diagnostic work-up of patients with peripheral nerve lesions includes a detailed evaluation of the clinical history, a thorough search for predisposing factors and trigger events, palpation at the suspected lesion site, specific provocation maneuvers and assessment of motor deficits (distribution, muscle power and atrophy), sensory disturbances (distribution and quality) and autonomic impairment (sudomotor activity) — all embedded in a careful standard neurological examination. Motor deficits are best evaluated by a combination of manual muscle testing and functional evaluation of all individual muscles (with the hand and arm put into a normal position because wrist drop and other positioning abnormalities might pretend muscle weakness) (Labosky and Waggy 1986). Quantitative assessment of muscle strength, implicit to a proper monitoring of nerve recovery and re-innervation, may make use of a dynamometer or of the modified “Medical Research Council (MRC) grading scale for muscle power” (Medical Research Council of the United Kingdom 1978) (Table 3.1).


Carpal Tunnel Syndrome Ulnar Nerve Nerve Conduction Study Compound Muscle Action Potential Cubital Tunnel 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2008

Authors and Affiliations

  • Stefan Kiechl
    • 1
  1. 1.Department of Neurology, Section for Electrodiagnosis (EMG/NLG)Innsbruck Medical UniversityInnsbruckAustria

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