肘部管症候群に合併したギオン管症候群の1例

A Case of Guyon's Canal Syndrome Associated with Cubital Tunnel Syndrome

Ⅰ．はじめに

　手掌部での尺骨神経の絞扼性障害であるギオン管症候群は，肘部管症候群と比較し発生頻度が低く，また，疾患の認知度も低いことから見逃されやすい疾患である．今回われわれは，肘部管症候群の術後残存症状がギオン管症候群に対する神経剝離術により改善し，良好な臨床経過をたどった1例を経験したので報告する．

　A 51-year-old man had a 1-year history of numbness on the ulnar side of the 4th finger, the 5th finger, and the ulnar side of the forearm, and weakness of the right hand. The Spurling sign was negative, and cervical radiography and magnetic resonance imaging revealed no abnormality. The Tinel-like signs at the Guyon's canal and cubital tunnel were positive. The diagnosis upon electrophysiological examination was cubital tunnel syndrome and Guyon's canal syndrome, but the possibility of Guyon's canal syndrome was high. Based on the presence of numbness in the forearm, the Tinel-like sign at the cubital tunnel, and the high incidence rate of cubital tunnel syndrome, an operation for cubital tunnel syndrome was performed. After the first operation, the numbness in the forearm was improved, but numbness in the 4th and 5th fingers, and weakness of the right hand remained, and the Tinel-like sign at the Guyon's canal also remained positive. The second operation for Guyon's canal syndrome was performed a month after the first operation for cubital tunnel syndrome. After the second operation, the residual symptoms improved gradually. Guyon's canal syndrome is a rare condition, but it may be considered a causative factor in patients with ulnar neuropathy.