Abstract | Cilj:Analiza prevalencije, dobi, spola, tipa, distribucije i etiologije elektroneurografski detektiranih kompresivnih mononeuropatija kod ispitanika pregledanih u laboratoriju za elektromioneurografiju (EMNG) Poliklinke Glavić u Dubrovnik u tijekom 2022. godine.
Ispitanici i metode:U ovom retrospektivnom istraživanju analizirani su rezultati elektroneurografske obrade provedene na 245 ispitanika. Kriterij uključenja u istraživanje bila je elektroneurografska detekcija različitih kompresivnih mononeuropatija. U istraživanje je uključeno 87 ispitanika.
Rezultati: Kompresivne mononeuropatije različiteetiologije dijagnosticiranesu kod 35,5% ispitanika. Od ukupnog broja bolesnika 36 (41%) čine osobe muškog spola, a 51 (59%) osobe ženskog spola. Najmlađi pacijent imao je 18 godina, a najstariji 85 godina. Najveći dio od ukupnog broja ispitanika s kompresivnom mononeuropatijom čine pacijenti u dobnom intervalu od 41 do 60 godina s udjelom od 44,83%. Prema tipu kompresivne mononeuropatije, na rukama je najzastupljeniji sindrom karpalnogatunela (74,7%), a na nogama sindrom peronealnog tunela (5,26%). Prema stupnju težine kompresivne mononeuropatije najzastupljeniji su bili pacijenti s blažim (46%), a najrjeđi s ekstremnim (8%) stupnjem bolesti.Prema lokalizaciji kompresivne mononeuropatije dominira afekcija ruku (90,8%), dok je afekcija nogu (6,9%) ili ruku i nogu (2,3%) značajno rjeđa.Kompresivne mononeuropatije na rukama najčešće su registriraneobostrano (70%), a značajno rjeđe samo na jednoj ruci i to podjednako na desnoj i lijevoj (po 15%).Kompresivne mononeuropatije na nogama najčešće su registriranena desnoj nozi (71,5%), rjeđe na lijevoj nozi (28,5%), dok nije zabilježen niti jedan slučaj istovremene prisutnosti kompresivne mononeuropatije na obje noge. Jedna kompresivna mononeuropatija registriranaje kod 45 ispitanika (33,3%), dvije kod 37 ispitanika (54,8%), tri kod 4 ispitanika (8,9%) te četiri kod 1 ispitanika (3%). Od čimbenika rizika za nastanak sindroma karpalnoga tunela najčešće je registrirana profesija, dijabetes i hipotireoza, kod sindroma kubitalnogatunela profesija i reumatoidni artritis, kod Mb. Roth pretilost i hipotireoza te kod sindromaperonealnog tunela uslijed kompresije n.peroneus comm.u području glavice fibule,trauma i hereditarna neuropatija sa sklonošću kompresivnim kljenutima(HNPP, engl. hereditary neuropathy with liability to pressure palsies). 2
Zaključci:EMNG obrada predstavlja zlatni standard u dijagnostici kompresivnih mononeuropatija. Kompresivne mononeuropatije su uz kompresivne radikulopatije i polineuropatije najčešći klinički entiteti dijagnosticirani EMNG-om. Sindrom karpalnoga tunela jenajčešća kompresivna mononeuropatija u općoj populaciji. |
Abstract (english) | Aim:Analysis of the prevalence, age, gender, type, distribution, and etiology of electroneurographically detected entrapment syndromes in subjects examined in the EMNG laboratory of Glavić Polyclinic in Dubrovnik during 2022.
Patients and methods:In this retrospective study, the results of nerve conductive studies performed on 245 subjects were analyzed. The criterion for inclusion in the research was the electroneurographic detection of variousentrapment syndromes. 87 patients were included in the research.
Results:Entrapment syndromes of various etiologies were diagnosed in 35.5% of respondents. Out of the total number of patients, 36 (41%) are male, and 51 (59%) are female. The youngest patient was 18 years old, and the oldest was 85 years old. The largest part of the total number of people with entrapment syndrome is made up of patients in the age range of 41 to 60 years, with a share of 44.83%. According to the type of entrapment syndrome, carpal tunnel syndrome is the most common on the hands (74.7%), and peroneal tunnel syndrome on the legs (5.26%). According to the degree of severity of the entrapment syndrome, the most represented patients were those with a mild (46%), and the rarest had an extreme (8%) degree of the disease. According to the localization of the entrapment syndrome, the affection of the hands dominates (90.8%), while the affection of the legs (6.9%) or hands and feet (2.3%) is significantly less common. Entrapment syndromes on the hands are most often registered bilaterally (70%), and significantly less often on only one hand, equally on the right and left (15% each). Entrapment syndromes on the legs were most often registered on the right leg (71.5%), less often on the left leg (28.5%), and not a single case of simultaneous presence of entrapment syndrome on both legs was recorded. One entrapment syndrome was registered in 45 subjects (33.3%), two in 37 subjects (54.8%), three in 4 subjects (8.9%), and four in 1 subject (3%). Among the risk factors for the occurrence of carpal tunnel syndrome, the most frequently registered were profession, diabetes, and hypothyroidism; in the case of cubital tunnel syndrome, profession and rheumatoid arthritis; in Mb. Roth, obesity and hypothyroidism; and in peroneal tunnel syndrome, due to compression of common peroneal nerve in the region of fibular head, trauma and hereditary neuropathy with liability to pressure palsies(HNPP).4
Conclusions:Electromyography and nerve conduction studies represents the gold standard in the diagnosis of entrapment syndromes. Along with compressive radiculopathies and polyneuropathies, entrapment syndromes are the most common clinical entities diagnosed by electromyography and nerve conduction studies. Carpal tunnel syndrome is the most common entrapment syndrome in the general population. |