The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome in Bangladeshi Population

Abstract

Introduction: The CTS is one of the clinical syndromes, it was experienced by the patients from numbness, tingling, burning and or pain associated with localized compression of the median nerve at the wrist. Median nerve with the carpel tunnel (CTS) is localized and it was compressed in median nerve, resulting in mechanical compression and local ischemia has been associated with age and sex matched control. Objective: To assess The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome in Bangladesh Population. Methods: A prospective study was conducted at Department of Neurology, Uttara Adhunik Medical College Hospital (UAMCH), Uttara, and Dhaka, Bangladesh from January to December 2021. A total 100 case were prospectively observed for the period of six months 50 patients’ with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined. Based on clinical assessment, the study patients were divided into 03 groups with mild CTS, moderate CTS and severe CTS respectively as per Mackinnsons classification. The relationship between the clinical severity grade and various nerve conduction study parameters were correlated. The study was correlated with age and gender matched control intervention and we extrapolate the any significant correlation between the clinical grades and various attributes of study traits. All the traits were carefully assessed by using logistic regression analysis and Fisher F- test statistics. Results: Out of 50 patients with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined. The Left hand was involved in 11patients; right hand in 19 patients & 20 patients had involvement of both hands. Numbness and tingling of hand and first three fingers was the most common presenting symptom. Phalens test was positive 30 (60.0%) of our patients. 7(14.0%) pts had hypothyroidism, 10(20%) patients showed raised DM and 4(8.0%) patients showed lipid profile abnormalities. Both male and female sex ratio was 1:3. All cases were considered for the study. The distal motor latency was significantly correlated with different age group of the population and CMAP and conduction velocity not shows any significant relation with clinical severity of CTS. Since, the median sensory latency and nerve conduction velocity seen in study population and well apprehension with clinical different grading of CTS. Conclusion: Summing of the results concludes that, the sensory conduction appears to be more sensitive (95%) AUC 0.89 and significantly correlated when compared to motor conduction attributes, the correlation besides with clinical severity of CTS apart from gender and age matched cases.