Whenever there was more than 10% drop in the compound muscle action potential (CMAP) amplitude between the wrist and below-elbow sites on routine ulnar motor study, median nerve was stimulated at wrist and at antecubital fossa while active electrode on abductor digiti minimi
Table 3 Increasing sensitivity of muscles to neuromuscular blockade Diaphragm Corrugator supercilii Laryngeal adductors Orbicularis occuli Abdominal rectus Abductor digiti minimi
Adductor pollicis = first dorsal Interosseous Genioglossus muscles Masseter Pharyngeal Note: "Increasing" is from top to bottom.
Physical examination revealed claw hand deformity, weakness in the abductor digiti minimi
muscle, intrinsic muscle atrophy, and numbness on the ulnar side in his left hand.
Pathologic decrement during repetitive nerve stimulation, 25.8–46.1% amplitude reduction of the fifth compound muscle action potential compared with the first during a train of supramaximal nerve stimulations at 3 Hz in the left abductor digiti minimi
and right deltoid strongly suggests dysfunction of the NMJ.
The anomalous muscle originated from the anteromedial aspect of the palmaris longus tendon about 3.5 cm proximal to the wrist crease and inserted over the fascia of the abductor digiti minimi
In the myographic examination, the deltoid and abductor digiti minimi
muscles from the upper extremity and vastus lateralis and gastrocnemius muscles from the lower extremity were examined.
The surface was metal plated, stimulating electrodes were placed at 5 cm below the medial epicondyle and at 5 cm above the medial epicondyle and the recording electrodes were placed over the abductor digiti minimi
(ADM) muscle on the ulnar side of the hand i.e.
The different local flaps for hind foot defects including dorsalis artery flap (1), abductor hallucis and abductor digiti minimi
muscle flaps (2,3) have inadequate tissue and limited arc of rotation thereby limiting their frequent use.
On examination, there was weakness and wasting of the small muscles of the left hand and anesthesia of the ulnar side of the hand tested by Semmes Weinstein Monofilaments.5 Voluntary muscle testing (VMT) revealed severe weakness of the hypothenar muscles, Abductor Digiti Minimi
(ADM) muscle and of the interossei muscles of the left hand (MRC grade 0).
Ulnar compound muscle action potential latencies were recorded at abductor digiti minimi
(ADM) muscle belly (motor point) with stimulation at 8 cm proximal to it.
Methods: We studied the F waves of 152 ulnar nerves recorded from abductor digiti minimi
in 82 patients with ALS.
Stimulation Points for Ulnar Nerve (Motor): (i) [S.sub.1]--placed at wrist at the second distal most crease just medial/lateral to flexor carpi ulnaris; (ii) [S.sub.2]--placed slightly above ulnar groove at the elbow; (iii) Ground electrode- dorsum of the hand; (iv) Recording electrode- at the valley of abductor digiti minimi
; (v) Reference electrode - distal to the active electrode.