Electrodiagnostic evaluation of patients with carpal tunnel syndrome regarding the presence of subjective and physical findings.

Abstract

The aim of our study was to evaluate the changes of median nerve conduction velocities by electrodiagnostic procedure in carpal tunnel syndrome (CTS) patients with and without present subjective and physical findings. We have evaluated 116 patients that were diagnosis with CTS. Subjective findings: weakness, numbness and night pain were analyzed. Further physical findings were evaluated: Tinels sign, muscles hypotrophy and weakness according to muscle manual test (MMT). Duration of complaints was evaluated as well. Electroneurographic findings included: estimation of median nerve motor terminal latency (mMTL), sensory velocity (mSV) and motor velocity (mMV). Significantly longer complaints were present in patients who experienced night pain (p=0.015) and those with muscles weakness on MMT (p=0.016). Statistically significant increase for mMTL values was noticed for patients with Tinels sign (p=0.045), present muscles hypotrophy (p=0.001) and weakness on MMT (p=0.001). There is significant decrease for mMV in group with present Tinels sign (p=0.048), muscle hypotrophy (p=0.003) and weakness on MMT (p=0.002), and for mSV in group with present muscle hypotrophy (p=0.008) and group with weakness on MMT (p=0.019). Multivariate logistic regressional analysis shown that only for hypotrophy, mMTL variable presents significant independent contributor (p=0.009). For the diagnosis confirmation and treatment planning along with elecroneurography it is necessary to evaluate patients with CTS clinically, since different clinical manifestations are correlating in different degree with electroneurographic findings.