Ultrasonographic and Electrophysiologic Assessment of Ulnar and Median Nerves in Spastic Upper Limbs in Chronic Stroke Patients

Abstract

Background: Stroke is the primary cause of long-term disability and mortality among adults and is classified as a chronic illness. After  suffering a stroke, spasticity manifests in around thirty percent of cases.

Aim: To evaluate the effect of spasticity in chronic hemiplegic  upper extremities on electrophysiological and morphological characteristics of the median and ulnar nerves.

Subjects and methods:  This was cross-sectional research that was performed on 50 patients with chronic stroke at the Clinical Neurophysiology Unit, Neurology  Department of Suez Canal University Hospitals, Suez Canal University and Ultrasonography Unit, Diagnostic Radiology Department,  Ismailia, Egypt, from May 2021 to January 2023. All the patients were subjected to clinical evaluations: (Spasticity evaluation: including  Brunnstrom Recovery Stages (BRS) and ultrasonographic measurements.

Results: There was a statistically significant positive moderate  association among ultrasonographic measures of median nerve (distal) and median nerve (proximal). On the paretic side, motor  conduction velocities of the median nerve were significantly delayed (mean±SD) (48.3± 9.5) when compared with the non-paretic side  (mean±SD) (54.4± 8.3) and pvalue (0.020) demonstrated that there were statistically significant variances. The F-wave latencies of the  median nerve were significantly higher on the paretic sides (mean ± SD) (32.2± 5.1) when compared with the non-paretic (mean ± SD)  (27.5± 3.9) side, and the p- value (0.011) showed that there were statistically significant differences.

Conclusion: We concluded that stroke  peripheral nerve cases seem to be influenced electrophysiologically on the paretic side. But according to US measurements, they  weren’t affected.