Abstract
The purpose of this study is to evaluate prospectively the sensitivities of conventional and new electrophysiological techniques and to investigate their relationship with the body mass index (BMI) in a population of patients suspected of having carpal tunnel syndrome (CTS).In this study, 165 hands of 92 consecutive patients (81 female, 11 male) with clinical diagnosis of CTS were compared to reference population of 60 hands of 30 healthy subjects (26 female and 4 male). Extensive sensory and motor nerve conduction studies (NCSs) were performed in the diagnosis of subtle CTS patients. Also, the patients were divided into subgroups and sensitivities were determined according to BMI.The mean BMI was found to be significantly higher in the CTS than in the control group (p < 0.001). The sensitivity of the median sensory nerve latency (mSDL) and median motor distal latency (mMDL) were 75.8% and 68.5%, respectively. The most sensitive parameters of sensory and motor NCSs were the difference between median and ulnar sensory distal latencies to the fourth digit [(D4M-D4U), (77%)] and the median motor terminal latency index [(mTLI), (70.3%)], while the median-to-ulnar sensory action potential amplitude ratio (27%) and the median-thenar to ulnar-hypothenar motor action potential amplitude ratio (15%) were least sensitive tests. Sensory tests were more sensitive than motor NCSs. Combining mSDL with D4M-D4U, and mMDL with mTLI allowed for the detection of abnormalities in 150 (91%) and 132 (80%) hands, respectively. Measurements of all NCSs parameters were abnormal in obese than in non-obese patients when compared to the BMI.The newer nerve conduction techniques and combining different NCSs tests are more sensitive than single conventional NCS test for the diagnosis of suspected CTS. Meanwhile, CTS is associated with increasing BMI.
Highlights
The carpal tunnel syndrome (CTS), caused by compression of the median nerve at the wrist, is considered to be the most common entrapment neuropathy in adults, with a 10% lifetime risk in the general population [1]
Patients Ninety two patients (165 hands) with a clinical diagnosis of CTS were compared to a reference population of 60 hands from 30 controls
Sensory parameters were more sensitive than motor Nerve conduction studies (NCSs)
Summary
The carpal tunnel syndrome (CTS), caused by compression of the median nerve at the wrist, is considered to be the most common entrapment neuropathy in adults, with a 10% lifetime risk in the general population [1]. Conventional electrophysiological studies have been useful in the (page number not for citation purposes). Journal of Brachial Plexus and Peripheral Nerve Injury 2009, 4:12 http://www.jbppni.com/content/4/1/12 diagnosis of this condition [2,3,4,5]. Electrophysiological testing remains an essential technique for quantifying median nerve function in CTS due to its inherent reliability, reproducibility, and objectivity. Nerve conduction studies (NCSs) measure peripheral nerve function directly without subjective bias and without contamination by central nervous system pathways [6]. Median sensory and motor NCSs confirm a clinical diagnosis of CTS in patients with a high degree of sensitivity and specificity [4]. Many authors have attempted to determine the sensitivity of the various tests for early diagnosis of CTS, but it is unclear which is the best
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of brachial plexus and peripheral nerve injury
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
