Abstract
Background: For the preoperatively often required confirmation of clinically defined carpal tunnel syndrome (CTS), sensory as well as motor nerve conduction studies can be applied. The aim of this study was to test the sensitivity of specific motor nerve conduction tests in comparison with, as well as in addition to, sensory nerve conduction tests.Methods: In 162 patients with clinically defined CTS, sensory and motor nerve conduction tests were performed prospectively. Sensitivity and specificity of all tests were computed. Also, Receiver Operating Characteristic (ROC) analyses were conducted.Results: Sensitivity for all sensory tests was at least 79.4% (DIG1). All tests had a specificity of at least 95.7%. The motor conduction test with the highest sensitivity was the TLI-APB (81.3%); its specificity was 97.9%.Conclusion: In the electrophysiological confirmation of CTS, sensory nerve conduction tests and terminal latency index have a high sensitivity. If, however, sensory nerve action potentials cannot be recorded, all motor nerve conduction tests have a high sensitivity.
Highlights
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy [1, 2]
It has previously been established that sensory nerve conduction studies are the most sensitive electrodiagnostic tests to confirm the diagnosis of CTS
We focused on the group of CTS patients whose sensory nerve action potentials could not be recorded; we tried to evaluate which motor nerve conduction test was the best alternative in these specific cases in terms of sensitivity
Summary
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy [1, 2]. Usually, the diagnosis can be reliably made on the basis of clinical signs and symptoms. Sensory nerve action potentials (SNAP) may not be recordable [4] In this case, motor nerve conduction studies are the only electrophysiological means to confirm the clinically defined diagnosis of CTS [5]. Other motor nerve conduction studies are [1] the absolute value of the DML of the compound muscle action potential (CMAP) of the second lumbrical muscle [2] comparison of the motor latency of the CMAP of the lumbrical muscle with that of the interosseous muscle after stimulation. For the preoperatively often required confirmation of clinically defined carpal tunnel syndrome (CTS), sensory as well as motor nerve conduction studies can be applied. The aim of this study was to test the sensitivity of specific motor nerve conduction tests in comparison with, as well as in addition to, sensory nerve conduction tests
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