Physiologic changes of compound muscle action potentials related to voluntary contraction and muscle length in carpal tunnel syndrome

2005 ◽  
Vol 15 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Byung-Jo Kim ◽  
Elaine S. Date ◽  
Byung Kyu Park ◽  
Bryan Y. Choi ◽  
Sang-Heon Lee
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Action Potentials ◽  
Muscle Length ◽  
Voluntary Contraction ◽  
Muscle Action ◽  
Compound Muscle Action Potentials ◽  
Tunnel Syndrome

scholarly journals Median-to-Ulnar Nerve Communication in Carpal Tunnel Syndrome: An Electrophysiological Study

2021 ◽  
Vol 13 (3) ◽  
pp. 304-314
Author(s):  
Vincenzo Di Stefano ◽  
Andrea Gagliardo ◽  
Filomena Barbone ◽  
Michela Vitale ◽  
Laura Ferri ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Action Potentials ◽  
Electrophysiological Study ◽  
Interpretation Errors ◽  
Communicating Branch ◽  
Compound Muscle Action Potentials ◽  
Tunnel Syndrome ◽  
Ulnar Nerve Lesions

The median-to-ulnar communicating branch (MUC) is an asymptomatic variant of the upper limb innervation that can lead to interpretation errors in routine nerve conduction studies. The diagnosis of carpal tunnel syndrome (CTS) or ulnar nerve lesions can be complicated by the presence of MUC. In this study, we describe electrophysiological features of MUC in CTS patients presenting to our clinic. We enrolled MUB cases from consecutive CTS patients referred to our laboratory between the years 2014 and 2019. MUC was present in 53 limbs (36 patients) from the studied population. MUC was bilateral in 53% of patients. MUC type II was the most common subtype (74%), followed by types III and I; more coexisting MUC types were found in the majority of tested limbs. A positive correlation was demonstrated between the severity of CTS and the presence of positive onset, faster CV, or a double component of the compound muscle action potentials. We emphasize the importance of suspecting the presence of MUC in CTS in the presence of a positive onset or a double component in routine motor conduction studies.

A novel approach to the diagnostic assessment of carpal tunnel syndrome based on the frequency domain of the compound muscle action potential

2020 ◽  
Vol 65 (1) ◽  
pp. 61-71
Author(s):  
Veysel Alcan ◽  
Hilal Kaya ◽  
Murat Zinnuroğlu ◽  
Gülçin Kaymak Karataş ◽  
Mehmet Rahmi Canal
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Action Potential ◽  
Carpal Tunnel ◽  
Compound Muscle Action Potential ◽  
Confusion Matrix ◽  
Maximum Power ◽  
Muscle Action ◽  
Muscle Action Potential ◽  
Tunnel Syndrome ◽  
The Mean

AbstractConventional electrophysiological (EP) tests may yield ambiguous or false-negative results in some patients with signs and symptoms of carpal tunnel syndrome (CTS). Therefore, researchers tend to investigate new parameters to improve the sensitivity and specificity of EP tests. We aimed to investigate the mean and maximum power of the compound muscle action potential (CMAP) as a novel diagnostic parameter, by evaluating diagnosis and classification performance using the supervised Kohonen self-organizing map (SOM) network models. The CMAPs were analyzed using the fast Fourier transform (FFT). The mean and maximum power parameters were calculated from the power spectrum. A counter-propagation artificial neural network (CPANN), supervised Kohonen network (SKN) and XY-fused network (XYF) were compared to evaluate the classification and diagnostic performance of the parameters using the confusion matrix. The mean and maximum power of the CMAP were significantly lower in patients with CTS than in the normal group (p < 0.05), and the XYF network had the best total performance of classification with 91.4%. This study suggests that the mean and maximum power of the CMAP can be considered as less time-consuming parameters for the diagnosis of CTS without using additional EP tests which can be uncomfortable for the patient due to poor tolerance to electrical stimulation.

scholarly journals Clinical predictors of surgical outcomes of severe carpal tunnel syndrome patients: utility of palmar stimulation in a nerve conduction study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuichi Sasaki ◽  
Tohru Terao ◽  
Emiko Saito ◽  
Keiichiro Ohara ◽  
Shotaro Michishita ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Action Potential ◽  
Carpal Tunnel ◽  
Compound Muscle Action Potential ◽  
Sensory Nerve ◽  
Sensory Nerve Action Potential ◽  
Muscle Action ◽  
Muscle Action Potential ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome

Abstract Background Carpal tunnel syndrome is a common peripheral nerve compression disorder. However, there is no established opinion regarding the predictors of symptom improvement after surgery. This study aimed to identify the predictors of surgical outcomes of severe carpal tunnel syndrome patients. Methods In the patients who underwent a carpal tunnel syndrome surgery, we selected the patients who had a preoperative Bland’s classification of grade 5 or 6, and assessed for the changes in Bland’s classification grade before and after surgery. Those who showed improvement from preoperative grades 5–6 to postoperative grades 1–4 comprised the improvement group. In contrast, those who did not show improvement and had postoperative grades 5 or 6 comprised the non-improvement group. In a nerve conduction study, amplitudes of the compound muscle action potential and sensory nerve action potential of the palms were assessed between the improvement and non-improvement groups. Results Among the 60 hands of 46 patients who had a preoperative Bland’s classification of grade 5 or 6, 49 hands of 37 patients comprised the improvement group, and 11 hands of 9 patients comprised the non-improvement group. The amplitudes of the compound muscle action potential and sensory nerve action potential of the palms before surgery were significantly higher in the improvement group. The degree of improvement in Bland’s classification grade was correlated with the degree of clinical symptom improvement. Conclusions Amplitudes of compound muscle action potential and sensory nerve action potential before surgery induced by palmar stimulation can predict improvements in nerve conduction study scores and clinical findings after surgical treatment.

scholarly journals Surgery of True Recurring Median Carpal Tunnel Syndrome with Synovial Flap by Wulle Plus Integument Enlargement Leads to a High Patient’s Satisfaction and Improved Functionality

2019 ◽  
Vol 8 (12) ◽  
pp. 2094
Author(s):  
Stephan Payr ◽  
Thomas M. Tiefenboeck ◽  
Veith Moser ◽  
Edvin Turkof
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction Velocity ◽  
Compound Muscle Action Potential ◽  
Sensory Nerve ◽  
Muscle Action ◽  
Patient’S Satisfaction ◽  
Muscle Action Potential ◽  
Tunnel Syndrome ◽  
Tissue Flap

This prospective study was conducted to investigate electrophysiological qualities and patient’s satisfaction of a synovial gliding tissue flap in treating true recurring carpal tunnel syndrome. In 14 patients (11 women, three men), 15 median nerves were included in this retrospective study. For all 15 nerves, motor and sensory nerve conduction velocity, compound muscle action potential, a Visual Analogue Scale-score (VAS-score) questionnaire and an adapted Levine-Test were evaluated pre- and postoperatively. All participants underwent operative neurolysis of the median nerve, which was then enwrapped by a synovial gliding tissue flap. Eleven procedures were completed by integument enlargement. Follow-up period was 12 months. Postoperatively, distal latency decreased significantly by 15.6%. Compound muscle action potential and sensory nerve conduction velocity did not improve significantly. VAS score regarding pain reduced highly significantly with 74.1%. The adapted Levine-Test function score improved highly significantly with 39.2%. The synovial gliding tissue flap lead to an excellent patient’s satisfaction for treating true recurring carpal tunnel syndrome. Primary wound closure should be completed with integument enlargement if needed.

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