79. Can we differentiate diabetic polyneuropathy (DPN) from carpal tunnel syndrome (CTS) by evaluating the sensory conduction distal to the palm?

INTRODUCTION Carpal tunnel syndrome has been reported by some to have a less satisfactory outcome in older patients following surgery. However, this impression is not supported by other investigators but no objective explanation has been suggested for these differences. In our department, such patients are routinely treated with night wrist splints and, if this is unsatisfactory, they are investigated with nerve conduction studies prior to surgery. PATIENTS AND METHODS This paper reports the neurophysiological outcome in a young (< 40 years of age) and an older (> 60 years of age) group of patients with clinical bilateral carpal tunnel syndrome who did not benefit from splints. RESULTS The results showed that both the motor and sensory conduction speeds are significantly lower in the older age group. More importantly in the older group, half had one or more hands where the sensory conduction was absent. In four out of these 10 patients this finding was bilateral and three patients had unilateral absent motor conduction. In the younger group, no patient had absent conduction. CONCLUSIONS Poor surgical outcome in some older patients may be because of irreversibly damaged nerves prior to surgery and pre-operative neurophysiology is, therefore, recommended both for clinical and medicolegal reasons.

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Early diagnosis of carpal tunnel syndrome: Comparison of sensory conduction studies of four fingers

Muscle & Nerve ◽

10.1002/(sici)1097-4598(199811)21:11<1543::aid-mus28>3.0.co;2-# ◽

1998 ◽

Vol 21 (11) ◽

pp. 1543-1545 ◽

Cited By ~ 11

Author(s):

S. Terzis ◽

C. Paschalis ◽

I.C. Metallinos ◽

T. Papapetropoulos

Keyword(s):

Carpal Tunnel Syndrome ◽

Early Diagnosis ◽

Carpal Tunnel ◽

Sensory Conduction ◽

Tunnel Syndrome

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Natural history of median nerve sensory conduction in industry: Relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years

Muscle & Nerve ◽

10.1002/(sici)1097-4598(199806)21:6<711::aid-mus2>3.0.co;2-a ◽

1998 ◽

Vol 21 (6) ◽

pp. 711-721 ◽

Cited By ~ 77

Author(s):

Peter A. Nathan ◽

Richard C. Keniston ◽

Lee D. Myers ◽

Kenneth D. Meadows ◽

Richard S. Lockwood

Keyword(s):

Carpal Tunnel Syndrome ◽

Natural History ◽

Median Nerve ◽

Carpal Tunnel ◽

Sensory Conduction ◽

History Of ◽

Tunnel Syndrome ◽

Industry Relationship

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Can Palm Stimulation Differentiate Diabetic Polyneuropathy From Carpal Tunnel Syndrome?

Journal of Clinical Neurophysiology ◽

10.1097/wnp.0000000000000036 ◽

2014 ◽

Vol 31 (2) ◽

pp. 169-174 ◽

Cited By ~ 3

Author(s):

Eiichi Ito ◽

Masahiro Sonoo ◽

Tomoko Iwanami ◽

Teruo Shimizu ◽

Makoto Iwata

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Diabetic Polyneuropathy ◽

Tunnel Syndrome

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Power Spectral Analyses of Index Finger Skin Blood Perfusion in Carpal Tunnel Syndrome and Diabetic Polyneuropathy

Experimental Diabetes Research ◽

10.1155/2011/465910 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8

Author(s):

Han-Wei Huang ◽

I-Ming Jou ◽

Chien-Kuo Wang ◽

Pei-Yin Chen ◽

Wen-Chi Wang ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Blood Perfusion ◽

Diabetic Polyneuropathy ◽

Test Results ◽

Doppler Flowmetry ◽

Frequency Bands ◽

Skin Blood Perfusion ◽

Tunnel Syndrome ◽

Power Dispersion

The main purpose of this study was to investigate the applicability of frequency domain analysis on laser Doppler flowmetry (LDF) data recorded from the index fingers of patients with carpal tunnel syndrome (CTS) and diabetic polyneuropathy (DPN). Patients with numbness of the palm were recruited and grouped according to the results of electrophysiological examinations into 2×2 groups by the existence or nonexistence of CTS and/or DPN. Skin blood perfusion was recorded by LDF in both the neutral position and the maximally flexed position (the Phalen test). -transformation was utilized to decompose the recorded data into frequency bands, and the relative band power and power dispersion were calculated. Analysis of variance was used to test the effects of DPN, CTS, and the Phalen test results. The results showed that (1) DPN decreased the absolute power and the relative power in some frequency bands in both positions and CTS increased the power dispersion of some frequency bands only during the Phalen test and (2) there was no difference in the LDF results between patients with positive or negative Phalen test results.

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