臨床神経 indd
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1 157 C6 T1 C8/T1 TOS true neurogenic TOS T1 C8 Key Words : brachial plexopathy, sensory nerve conduction studies, needle EMG, thoracic outlet syndrome, neuralgic amyotrophy C5 T1 5 root trunk division cord
2 C5 terminal nerve 5 4 supraclavicular retroclavicular infraclavicular 4 Erb trunk root 1 early branching C5 C7 3 1 Horner Horner T1 nerve conduction study; NCS motor nerve con duction study; MCS sensory nerve conduction study; SCS somatosensory evoked potential; SEP 1 MCS MCS SCS compound muscle action potential; CMAP MCS CMAP MCS SCS MCS abductor pollicis brevis; APB T1 abductor digiti minimi; ADM C8 5 extensor indcis; EI
3 SCS LAC ; C6 ; C6/7 ; C6 C7 C8 ; C8 MAC ; T1 MCS APB T1 ADM C8 C8 MCS MCS CMAP MCS Erb CMAP Erb 2 SCS SCS SCS sensory nerve action potential; SNAP cervical spondylotic myelopathy; CSM cervical spondylotic radiculopathy; CSR SNAP CSR CTS double crush 6 7 SCS SCS C6 T1 4 SCS Cleveland Clinic Wilbourn Ferrante LAC MAC 7 SNAP
4 subclinical CMAP motor unit potential; MUP denervation CSR CSM CSR denervation 9 10 MUP multifidus CSR 4 SEP SEP Waller SEP 41 3 MCS SEP 13 SEP 1 TOS TOS true neurogenic TOS disputed neurogenic TOS TOS True neurogenic TOS CTS T1 C8 5 T1 C8 Morley Adson Allen TOS Roos 3 CTS True neurogenic TOS SCS MAC MCS APB ADM NCS TOS MCS Erb
5 161 3 True neurogenic TOS MMT APB 3 ADM 4 5 T1 MCS MAC SCS C8 MCS SCS SCS C6 C7 SCS T1 C Horner SCS MCS C8 C8 Levin 5 25 SCS 4 C NA NA 26 28
6 C C8 MCS SCS SCS MAC SNAP C8 C8 1 2 CSR NA NA NA NA SNAP : 35: , : 26: 23 30, 3 : Clinical Neuroscience 30: , Ferrante MA: Brachial plexopathies: classification, causes, and consequences. Muscle Nerve 30: , Levin KH, Wilbourn AJ, Maggiano HJ: Cervical rib and median sternotomy-related brachial plexopathies: a reassessment. Neurology 50: , Wilbourn AJ, Gilliatt RW: Double-crush syndrome: a critical analysis. Neurology 49: 21 29, : 25: , Ferrante MA, Wilbourn AJ: The utility of various sensory nerve conduction responses in assessing brachial plexopathies. Muscle Nerve 18: , Wilbourn AJ, Aminoff MJ: The electrodiagnostic examination in patients with radiculopathies. Muscle Nerve 21: ,
7 : 18: , Haig AJ, Moffroid M, Henry S, et al: A technique for needle localization in paraspinal muscles with cadaveric confirmation. Muscle Nerve 14: , Kimura J: Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice. F. A. Davis Company, Philadelphia, p 457, Jones SJ, Wynn Parry CB, Landi A: Diagnosis of brachial plexus traction lesions by sensory nerve action potentials and somatosensory evoked potentials. Injury 12: , : True neurogenic thoracic outlet syndrome TOS 40: , Roos DB: Thoracic outlet syndrome is underdiagnosed. Muscle Nerve 22: , Wilbourn AJ: Thoracic outlet syndrome is overdiagnosed. Muscle Nerve 22: , : true neurogenic TOS 25: , Plewa MC, Delinger M: The false-positive rate of thoracic outlet syndrome shoulder maneuvers in healthy subjects. Acad Emerg Med 5: , Nord KM, Kapoor P, Fisher J, et al: False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyogr Clin Neuro physiol 48: 67 74, Urschel HC Jr: Management of the thoracic-outlet syndrome. N Engl J Med 286: , Wilbourn AJ, Lederman RJ: Evidence for conduction delay in thoracic-outlet syndrome is challenged. N Engl J Med 310: , Urschel HC: Reply. N Engl J Med 310: 1053, Lederman RJ, Wilbourn AJ: Brachial plexopathy: recurrent cancer or radiation? Neurology 34: , Harper CM Jr, Thomas JE, Cascino TL, et al: Distinction between neoplastic and radiation-induced brachial plexopathy, with emphasis on the role of EMG. Neurology 39: , : C8 1 47: , England JD, Sumner AJ: Neuralgic amyotrophy: an increasingly diverse entity. Muscle Nerve 10: 60 68, Cruz-Martinez A, Barrio M, Arpa J: Neuralgic amyotrophy: variable expression in 40 patients. J Peripher Nerv Syst 7: , van Alfen N, van Engelen BG: The clinical spectrum of neuralgic amyotrophy in 246 cases. Brain 48: , : Keegan 39: , : 12: , Flaggman PPD, Kelly JJ Jr.: Brachial plexus neuropathy. An electrophysiologic evaluation. Arch Neurol 37: , Lo YL, Mills KR: Motor root conduction in neuralgic amyotrophy: evidence of proximal conduction block. J Neurol Neurosurg Psychiatry 66: , Watson BV, Nicolle MW, Brown JD: Conduction block in neuralgic amyotrophy. Muscle Nerve 24: , : 1 48: , 2006.
臨床神経 indd
131 40 3 131 139 2012 True neurogenic thoracic outlet syndrome TOS 1 2 3 2 1 1 4 5 3 1 6 3 1 TOStrue neurogenic TOS TNTOS disputed neurogenic TOS DNTOS TNTOS 12 TNTOS 4 Th1 TOS 7 6 DNTOS TNTOS Th1 DNTOS
臨床神経45-1.indb
59 Case of the Issue No. 9 carpal tunnel syndrome: CTS CTS CTS CTS nerve conduction study; NCS needle electromyography; nemg NCS carpal tunnel syndrome: CTS 1 CTS 4 CTS 45 65 1 3 2 CTS CTS 1999 American
臨床神経 indd
164 41 3 CTS CTS Key Words : carpal tunnel syndrome, nerve conduction study, sensory nerve action potential CTS CTS 10 1 2 CTS 1 3 4 CTS 1 Tinel Phalen Tinel CTS 1 Phalen Phalen Phalen Phalen 2 1/3 : 1
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55:155 1 1 * 2 1 1 1 1 神経原性胸郭出口症候群, 異所性鎖骨下動脈, 腕神経叢, 単肢筋萎縮症 胸郭出口症候群 (thoracic outlet syndrome; TOS) という疾患単位は, 定義に混乱があるものの, 腕神経叢および鎖骨下動脈の絞扼によっておこる上肢のしびれ, 肩こりなどを主訴とする疾患であると本邦では解釈されている 1). そのうちのほとんどを占める神経性
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