scholarly journals Transcarpal Median Sensory Conduction: Detection of Latent Abnormalities in Mild Carpal Tunnel Syndrome

1988 ◽  
Vol 15 (4) ◽  
pp. 388-393 ◽  
Author(s):  
Jacques De Léan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Diagnostic Yield ◽  
Sensory Nerve ◽  
Presumptive Diagnosis ◽  
Sensory Conduction ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome

ABSTRACT:The major slowing of nerve conduction in the carpal tunnel syndrome is located in the palm to wrist segment. The aim of this study is to develop a reliable, sensitive and accessible approach to measure transcarpal median sensory nerve conduction. For this purpose, a fast recovery amplifier with a stimulus artifact suppressor was designed by the author. On stimulation of digits II or III, evoked orthodromic sensory nerve action potentials were simultaneously recorded at the palm and at the wrist. Distances were determined with a ruler. Median sensory nerve conduction velocity was estimated from digit to palm and from palm to wrist in 80 healthy hands and 253 hands with a presumptive diagnosis of carpal tunnel syndrome. According to conventional criteria, 131 of the 253 hands from those suspected of carpal tunnel syndrome were thought to have median nerve compression. When transcarpal median sensory conduction velocity was taken into account, the diagnostic yield increased by 18.1%. The described technique provides a simple, sensitive and reliable method of diagnosing mild or early carpal tunnel syndrome.

Electrophysiological and Clinical Improvement in Non-Invasive Treatment of Carpal Tunnel Syndrome

2020 ◽  
Vol 20 ◽  
Author(s):  
Riccardo Marvulli ◽  
Giancarlo Ianieri ◽  
Grazia Devenuto ◽  
Marta Falcicchio ◽  
Giulia A. Gallo ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Sleep Quality ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Pantothenic Acid ◽  
Sensory Nerve ◽  
Sensory Nerve Conduction Velocity ◽  
Tunnel Syndrome

Background and Objective: Carpal tunnel syndrome (CTS) is the most common form of nerve entrapment. Clinically, various signs and symptoms compare due to overexposure to mechanical vibrations transmitted to the wrist bones and cartilage, resulting in compression of the sensory and motor nerve fibers of median nerve. Early symptoms include nocturnal paresthesia and electromyography reveals reduced sensory nerve conduction velocity. Aim of this study was to evaluate the efficacy of a dietary integrator composed of acetyl-L-carnitine, α-lipoic acid,quercetin, bromelain, pantothenic acid, C and B1 and B2 and B6 and B12 vitamins in patients with early (minimal) carpal tunnel syndrome. Methods: 36 patients (28 female and 8 male) with early CTS characterized by sensory nerve demyelination and inflammation of the transverse carpal ligament. Patients were divided into two groups, group A (18 patients received physical therapy) and group B (18 patients, received physical therapy and an oral integrator). Clinical (sleep quality questionnaire to measure severity of paresthesia) and neurophysiological assessment (Sensory Nerve Conduction Velocity) performed at baseline, and then at 30 and 60 days after treatment. Results: Sleep quality and Sensory Nerve Conduction Velocity data analysis show improvement in both groups at 30 and 60 days, with statistically difference between them in both time of analysis. Conclusions: In the early CTS, with sensory fibers damage, use of dietary integrator, such as Micronil Dol®, composed composed of acetyl-L-carnitine, α-lipoic acid,quercetin, bromelain, pantothenic acid, C and B1 and B2 and B6 and B12 vitamins can be effective in quick recovery of median nerve sensory.

scholarly journals Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands

2009 ◽  
Vol 67 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Dante Guilherme Velasco Hardoim ◽  
Guilherme Bueno de Oliveira ◽  
João Aris Kouyoumdjian
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Compound Action

OBJECTIVE: To compare a long-term carpal tunnel syndrome (CTS) on nerve conduction studies (NCS) in hands treated non-surgically. METHOD: We retrospectively selected 261 symptomatic CTS hands (166 patients), all of them confirmed by NCS. In all cases, at least 2 NCS were performed in an interval greater than 12 months. Cases with associated polyneuropathy were excluded. NCS parameters for CTS electrodiagnosis included a sensory conduction velocity (SCV) <46.6 m/s (wrist to index finger, 14 cm) and distal motor latency (DML) >4.25 ms (wrist to APB, 8 cm). RESULTS: 92.8% were women; mean age was 49 years (20-76); the mean interval between NCS was 47 months (12-150). In the first exam, the median sensory nerve action potential (SNAP) and the compound action muscular potential were absent in 9.8% and 1.9%, respectively. In the second/last exam, SCV worsened in 54.2%, remained unchanged in 11.6% and improved in 34.2%. SNAP amplitude worsened in 57.7%, remained unchanged in 13.1% and improved in 29.2%. DML worsened in 52.9%, remained unchanged in 7.6% and improved in 39.5%. Overall, NCS parameters worsened in 54.9%, improved in 34.3% and remained unchanged in 10.8%. CONCLUSION: Long-term changing in NCS of CTS hands apparently were not related to clinical symptomatology and could lead to some difficulty in clinical correlation and prognosis. Aging, male gender and absent SNAP were more related to NCS worsening, regardless the mean interval time between the NCS.

Assessment of Sensory Nerve Conduction in Carpal Tunnel Syndrome before, during and after Operation

1988 ◽  
Vol 13 (4) ◽  
pp. 386-390
Author(s):  
R. LUCHETTI ◽  
R. SCHOENHUBER ◽  
A. LANDI
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Prognostic Value ◽  
Sensory Nerve ◽  
Diagnostic Value ◽  
Control Subjects ◽  
Sensory Conduction ◽  
Tunnel Syndrome ◽  
Operative Findings

Sensory conduction velocities of the median nerve before, during and after operation were compared in nine patients with carpal tunnel syndrome and four controls, in order to evaluate the prognostic value of the pre-operative and intra-operative findings. Sensory conduction velocity was higher after operation than before in all patients (mean difference 31.33%), but not in control subjects. One patient showed a dramatic increase of 157% immediately after decompression. Comparing the intra-operative with the post-operative findings all patients but one showed an increase of antidromic sensory conduction velocity (mean 44.37%), while in control subjects again minimal changes were found (mean –4.25%). The study confirms the high diagnostic value of the pre-operative antidromic sensory conduction velocity findings. However, the prognostic value of both pre-operative and intra-operative ASCV findings is low.

scholarly journals Diagnosis and Management of Carpal Tunnel Syndrome in Children with Mucopolysaccharidosis: A 10 Year Experience

Diagnostics ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 5 ◽  
Author(s):  
Ivana Dabaj ◽  
Cyril Gitiaux ◽  
Daniela Avila-Smirnow ◽  
Jacques Ropers ◽  
Isabelle Desguerre ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Disease Diagnosis ◽  
Tunnel Syndrome

Introduction: Mucopolysaccharidoses (MPS) are rare and clinically heterogeneous lysosomal storage disorders. Carpal tunnel syndrome (CTS) is a frequent complication in MPS types I, II, VI, and VII. CTS symptoms are difficult to recognize in these children, and often there is a lack of appropriate investigations. Patients and methods: In this retrospective study, all MPS patients were referred to the electrodiagnostic (EDX) laboratory of a single academic center during a 10-year period. Forty-eight children underwent serial EDX studies for CTS diagnosis and follow-up after surgery. Forty-two patients were diagnosed with CTS. Sensory nerve conduction velocity (SNCV), distal motor latency (DML), and motor nerve conduction velocity through the wrist (MNCV-W) of the median nerve were reviewed and analyzed. Results: One-hundred-three EDX examinations were performed on 48 patients. The median age at disease diagnosis was 2.1 years versus 4.9 years for CTS diagnosis. Analysis of the series revealed that electrophysiological abnormalities of CTS could have started much earlier (before the age of 2 years or at diagnosis of MPS). Diagnosis was based on SNCV and DML results, and MNCV-W was taken into consideration. Bilateral CTS was frequent (88%) in the types of MPS studied in our population and was observed from the first year of life, and may not have be associated with obvious clinical symptoms. EDX studies also helped in the follow-up and detection of CTS relapses, thus leading to an early intervention allowing a better recovery. Conclusion: EDX studies should be performed promptly and regularly in these patients. Prospective studies are required in order to understand the effect of disease-specific therapies in preventing the development of CTS in these patients. Synopsis: EDX studies should be performed in MPS patients soon after diagnosis and during routine follow-up, before and after surgical decompression.

Value of Electrodiagnostic Tests in Carpal Tunnel Syndrome

2000 ◽  
Vol 25 (4) ◽  
pp. 361-365 ◽  
Author(s):  
A. F. DUDLEY PORRAS ◽  
P. ROJO ALAMINOS ◽  
J. I. VIÒUALES ◽  
M. A. RUIZ VILLAMAÒAN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Sensory Nerve ◽  
Sensory Nerve Conduction Velocity ◽  
Tunnel Syndrome ◽  
A Prospective Study

Eighty-five patients who were treated surgically for carpal tunnel syndrome were reviewed by a prospective study to assess the relationship between electrodiagnostic tests and clinical outcome. Before surgery all patients completed a self-administered questionnaire, and an electrophysiological examination was done to assess distal motor latency, sensory and motor amplitudes, and sensory nerve conduction velocity. After 6 months follow-up all these tests were repeated. There was significant correlation between improvement in sensory nerve conduction velocity and clinical improvement at follow-up.

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

2009 ◽  
Vol 52 (2) ◽  
pp. 63-68 ◽  
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.

scholarly journals When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome?

2021 ◽  
Vol 67 (4) ◽  
pp. 518-525
Author(s):  
Zuhal Özişler ◽  
Müfit Akyüz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Spontaneous Activity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Symptom Duration ◽  
Thenar Muscle ◽  
Distal Motor Latency ◽  
Motor Latency ◽  
Tunnel Syndrome

Objectives: This study aims to evaluate the predictors of standard nerve conduction study (NCS) parameters in determining the presence of axonal loss by means of spontaneous activity in patients with mild and moderate carpal tunnel syndrome (CTS). Patients and methods: Between May 2015 and April 2018, a total of 118 patients (11 males, 107 females; mean age: 52.3±10.6 years; range, 27 to 79 years) who underwent electrophysiological studies and were diagnosed with CTS were included. Demographic data of the patients including age, sex, and symptom duration were recorded. Electrodiagnostic studies were performed in all patients. All the needle electromyography (EMG) findings were recorded, but only the presence or absence of spontaneous EMG activities was used as the indicator of axonal injury. Results: In 37 (31.4%) of the patients, spontaneous activity was detected at the thenar muscle needle EMG. No spontaneous activity was observed in any of 43 (36.4%) patients with normal distal motor latency (DML). There were significant differences in DMLs, compound muscle action potential (CMAP) amplitudes, sensory nerve action potentials amplitudes, and sensory nerve conduction velocities between the groups with and without spontaneous activity (p<0.05). The multiple logistic regression analysis revealed that DML was a significant independent risk variable in determining presence of spontaneous activity. The most optimal cut-off value for median DML was calculated as 4.9 ms. If the median DML was >4.9 ms, the relative risk of finding spontaneous activity on thenar muscle needle EMG was 13.5 (95% CI: 3.6-51.2). Conclusion: Distal motor latency is the main parameter for predicting the presence of spontaneous activity in mild and moderate CTS patients with normal CMAP. Performing needle EMG of the thenar muscle in CTS patients with a DML of >4.9 ms may be beneficial to detect axonal degeneration in early stages.

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