Comparison of sensory nerve conduction in the palmar cutaneous branch and first digital branch of the median nerve: A new diagnostic method for carpal tunnel syndrome

Objectives: The aim of this study was to investigate the therapeutic effects of low-level laser therapy (LLLT) on clinical, ultrasonographic (US), and electrophysiological findings in carpal tunnel syndrome (CTS). Patients and methods: Between January 2015 and August 2015, 42 patients (7 males, 35 females; mean age: 50.4±8.7 years; range, 32 to 65 years) with mild-to-moderate CTS were randomly assigned to one of two groups: active LLLT (therapy group, n=22) 0.8 J/painful point and sham LLLT groups (n=20). Both groups wore neutral wrist orthoses. The patients were evaluated before and after 15 sessions of therapy (670 nm, 4 J/session over the carpal tunnel). Follow-up parameters included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) Symptom Severity Scale (SSS), Functional Status Scale (FSS), nerve conduction studies and US evaluation of the median nerve cross-sectional area (CSA), vascularization (via power Doppler), flattening ratio (FR), and palmar bowing of the flexor retinaculum. Results: Nocturnal paresthesia improved in both groups; however, pain and patients with a positive Phalen’s test reduced only in the therapy group (p=0.031). The FSS and SSS scores also improved only in the therapy group (p<0.001). Electrophysiologically, median sensory nerve conduction velocities showed a significant improvement only in the therapy group (p=0.002). The CSA, FR, and vascularization of the median nerve showed a significant improvement in the therapy group alone (p<0.001, p=0.048, and p=0.021, respectively). Conclusion: Improvements in the signs and symptoms of CTS and hand function, the improvements in sensory nerve conduction studies, and reduction in median nerve CSA, FR and vascularity in the LLLT group can be attributed to the anti-inflammatory and analgesic effects of LLLT. This study provides new US data demonstrating efficacy of LLLT along with a clinical and electrophysiological improvement. The LLLT seems to be an easily applied, non-invasive treatment option.

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Entrapment Neuropathy of the Palmar Cutaneous Branch of the Median Nerve Concomitant with Carpal Tunnel Syndrome: A Case Report

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2002.0809 ◽

2002 ◽

Vol 27 (6) ◽

pp. 583-585 ◽

Cited By ~ 8

Author(s):

T. WADA ◽

T. IMAI ◽

S. ISHII

Keyword(s):

Case Report ◽

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Nerve Conduction Studies ◽

Entrapment Neuropathy ◽

Palmar Cutaneous Branch ◽

Cutaneous Branch ◽

Tunnel Syndrome ◽

Monofilament Test

A case of the entrapment neuropathy of the palmar cutaneous branch of the median nerve, concomitant with carpal tunnel syndrome is presented. This report demonstrates that the Semmes–Weinstein monofilament test and nerve conduction studies can identify entrapment of the palmar cutaneous branch of the median nerve concomitant with carpal tunnel syndrome.

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Effect of Gabapentin on nerve conduction studies in carpal tunnel syndrome

Biomedical Research and Therapy ◽

10.15419/bmrat.v5i1.406 ◽

2018 ◽

Vol 5 (1) ◽

pp. 1923-1930 ◽

Cited By ~ 1

Author(s):

Reza Sabet ◽

Karamatollah Rahmanian ◽

Abdolreza Sotoodeh Jahromi ◽

Abdolhossein Madani

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Sensory Nerve ◽

Nerve Conduction Studies ◽

Quasi Experimental ◽

Group A ◽

Tunnel Syndrome ◽

Group B

Background: The most common type of neuropathy in adults is carpal tunnel syndrome (CTS) which is caused by compression of the median nerve at the wrist. Methods: This quasi-experimental study was conducted to determine the efficacy of gabapentin on nerve conduction studies in patients with mild CTS. The patients with mild CTS were randomly allocated into two groups. Group A received naproxen alone (500 mg/day, orally) while group B received both gabapentin (100-300 mg) and naproxen (500 mg/day, orally) for two months. Sensory nerve conduction velocity (SNCV) and distal motor latency (DML) were performed at baseline and two months after treatment. Results: There were no significant differences between the two groups with regards to the outcome parameters before initiation of intervention. The SNCV and DML showed no significant improvements in group A (p>0.05), whereas for group B the SNCV and DML of the median nerve were significantly improved at two months after treatment (p<0.001). Conclusion: Gabapentin was found to be effective for SNCV and DML in patients with mild CTS over a two-month period.

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Is Palmar Cutaneous Branch of the Median Nerve More Swollen in Carpal Tunnel Syndrome?

Annals of Rehabilitation Medicine ◽

10.5535/arm.21101 ◽

2021 ◽

Vol 45 (4) ◽

pp. 325-330

Author(s):

Ha Mok Jeong ◽

Young Ha Jeong ◽

Joon Shik Yoon

Keyword(s):

High Resolution ◽

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

The Other ◽

Cross Sectional ◽

Palmar Cutaneous Branch ◽

Cutaneous Branch ◽

Tunnel Syndrome ◽

Impairment Severity

Objective To investigate the characteristics of the palmar cutaneous branch of the median nerve (PCBMN) in patient with carpal tunnel syndrome (CTS) using high-resolution ultrasound.Methods Fourteen healthy volunteers (17 wrists) and 31 patients with CTS (41 wrists) were evaluated by high-resolution ultrasound. All patients were classified into three groups based on the electrophysiologic CTS impairment severity: mild, moderate, and severe. Using high-resolution ultrasound, the cross-sectional areas (CSAs) of the PCBMN were measured at the proximal wrist crease, bistyloid line, and distal wrist crease, and the largest CSA was defined as the maximal CSA.Results The maximal CSA of the PCBMN of the control, mild, moderate, and severe CTS groups were 0.27±0.08, 0.30±0.07, 0.35±0.10, and 0.47±0.13 mm2, respectively. The maximal CSA of the PCBMN was significantly larger in the severe CTS group than in the other groups.Conclusion The PCBMN could be concomitantly affected in patients with severe CTS.

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The Potential Benefit of Intracarpal Pressure Measurement in Endoscopic Carpal Tunnel Syndrome Surgery – An Analysis of EMG Findings and Pressure Values

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.106 ◽

2009 ◽

Vol 52 (2) ◽

pp. 63-68 ◽

Cited By ~ 2

Author(s):

Martin Kanta ◽

Edvard Ehler ◽

Jan Kremláček ◽

Svatopluk Řehák ◽

David Laštovička ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Pressure Measurement ◽

Nerve Conduction ◽

Motor Response ◽

Sensory Nerve ◽

Sensory Nerve Action ◽

Invasive Method ◽

Tunnel Syndrome

Endoscopic carpal tunnel syndrome surgery is a modern minimally invasive method of carpal tunnel decompression. However, the method does also have its critics, who emphasize that there is an increased rate of complications in comparison to open procedures. To further improve and optimize results of endoscopic surgery we used an intracarpal pressure sensor to verify the effect of carpal tunnel decompression. The endoscopic single portal approach was used in all cases. Median nerve conduction studies were performed prior to and 3 months after surgery. Two groups, those with pressure studies and those without, were then compared according to several EMG parameters such as: median nerve distal motor latency, amplitude of motor response, sensory nerve conduction velocity to the index finger, and amplitude of sensory nerve action potential. In both groups, we observed similarly significant improvements in all conduction parameters, except the amplitude of motor response, which did not change in either group, i.e. no difference in postoperative EMG between the two groups was observed. Despite this fact, intracarpal pressure measurement is still useful in localising the point in which the median nerve is compressed and provides valuable functional information on the level decompression achieved.

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