really nice video, Dr. Simon, Question: why the CMAP at wrist-level is also reduced if the damage of the nerve is at the level of ellbow? thanks a lot in advance.
Hi Meng, once the axons are damaged, the parts distal to the point of damage die back and then their associated muscle fibres atrophy as a result. So once there is established damage at the elbow, it follows all the way down too. Bw Simon
Thank you Dr. Very informative. I do have ulnar neuropathy at the elbow level. EMG showed compression for the motor branch. I have weak hand and some wasting muscles. Could after surgery be recovered
Hi Wasim, it depends on how bad it is, your general health and age, and so you'll have to ask your surgeon as its patient specific. Wishing you well, Simon
@@DrSimonFreilich I understand. Thank you so much Dr. I'm 44 years old. I have lost the abductor muscle but rest of muscles are not much lost. Thank you again. The problem is that they are very slow here in Spain. How much does it cost usually in private sector to do this operation
Hi Dr. Freilich I was wondering I could ask you a question from a patients perspective. I have chronic posterior elbow pain (tip of elbow) with intermittent burning sensations into my hand and very occasionally into the forearm too. There does n't appear to be a particular distribution pattern but I would say it is slightly more ulnar sided. Symptoms can be replicated by prolonged end of range elbow flexion. There is no numbness or loss of strength in my hands but a slight loss of triceps strength compared to the other arm. Triceps extension is particularly painful at the tip of the elbow. MRI of brain and spine were normal. MRI of elbows showed no evidence of ulnar nerve entrapment. Given the above do you think I would benefit from a nerve conduction? The burning sensations have been there for over 1 year. Thanks Sam.
@@DrSimonFreilich Just a follow up question. I saw an orthopaedic doctor last week who said I had cubital tunnel syndrome. He said he noticed some atrophy at the forearm near the ulnar nerve and some mild weakness of the little finger at my non-dominant arm by a test I can best describe as flicking each finger into in turn in to my other hand. Tinel's test was also positive but to be honest my hands can start burning as soon as I get out of bed so not sure if this test is useful. He said I needed surgical decompression. He also said a nerve conduction study would not be useful as the test could be negative and I could still have cubital tunnel syndrome. Is this correct? I also experience milder symptoms in my other hand and have tingling sensations in the left side of face daily, usually upon waking later subsiding, and occasional milder burning sensations in my feet. As I said before the burning sensations are more ulnar sided but can affect all my fingers and the back of my hands. Also my entire left hand can turn blue on cold exposure. Rheumatological causes have been excluded. Thank you I just wanted another opinion before committing to surgery. Currently I'm thinking of seeing a neurologist and perhaps getting the NCS anyway.
I'm a neurologist myself and really appreciate your vids for myself and my students!!
Thanks so much for your encouragement!
Dr Simon your videos are really helpful. Would like to hear on Radial nerve conduction studies as well.
really nice video, Dr. Simon, Question: why the CMAP at wrist-level is also reduced if the damage of the nerve is at the level of ellbow? thanks a lot in advance.
Hi Meng, once the axons are damaged, the parts distal to the point of damage die back and then their associated muscle fibres atrophy as a result. So once there is established damage at the elbow, it follows all the way down too. Bw Simon
Thank you Dr. Very informative. I do have ulnar neuropathy at the elbow level. EMG showed compression for the motor branch. I have weak hand and some wasting muscles. Could after surgery be recovered
Hi Wasim, it depends on how bad it is, your general health and age, and so you'll have to ask your surgeon as its patient specific. Wishing you well, Simon
@@DrSimonFreilich I understand. Thank you so much Dr.
I'm 44 years old.
I have lost the abductor muscle but rest of muscles are not much lost.
Thank you again. The problem is that they are very slow here in Spain. How much does it cost usually in private sector to do this operation
Hi Dr. Freilich I was wondering I could ask you a question from a patients perspective. I have chronic posterior elbow pain (tip of elbow) with intermittent burning sensations into my hand and very occasionally into the forearm too. There does n't appear to be a particular distribution pattern but I would say it is slightly more ulnar sided. Symptoms can be replicated by prolonged end of range elbow flexion. There is no numbness or loss of strength in my hands but a slight loss of triceps strength compared to the other arm. Triceps extension is particularly painful at the tip of the elbow. MRI of brain and spine were normal. MRI of elbows showed no evidence of ulnar nerve entrapment. Given the above do you think I would benefit from a nerve conduction? The burning sensations have been there for over 1 year. Thanks Sam.
Hi Sam. Probably not. Bw Simon
@@DrSimonFreilich Thank you for your response. Much appreciated.
@@DrSimonFreilich Just a follow up question. I saw an orthopaedic doctor last week who said I had cubital tunnel syndrome. He said he noticed some atrophy at the forearm near the ulnar nerve and some mild weakness of the little finger at my non-dominant arm by a test I can best describe as flicking each finger into in turn in to my other hand. Tinel's test was also positive but to be honest my hands can start burning as soon as I get out of bed so not sure if this test is useful. He said I needed surgical decompression. He also said a nerve conduction study would not be useful as the test could be negative and I could still have cubital tunnel syndrome. Is this correct? I also experience milder symptoms in my other hand and have tingling sensations in the left side of face daily, usually upon waking later subsiding, and occasional milder burning sensations in my feet. As I said before the burning sensations are more ulnar sided but can affect all my fingers and the back of my hands. Also my entire left hand can turn blue on cold exposure. Rheumatological causes have been excluded. Thank you I just wanted another opinion before committing to surgery. Currently I'm thinking of seeing a neurologist and perhaps getting the NCS anyway.