scholarly journals Frequency of Type-1 Berrettini's Connection in a Neurophysiology Laboratory

Author(s):  
Juan M. Duarte ◽  
Juan I. Rolón ◽  
Alicia B. Bertotti

Abstract Objective This study aims to estimate the frequency of Berrettini's ulnar-median nerves communication in a neurophysiology laboratory. Materials and Methods A total of 358 hands belonging to patients, both sexes, median age of 58 years, was studied. Antidromic sensory nerve conduction studies of the ulnar nerves, registered in digits III and IV were performed in search of the ulnar-median communication. A Berrettini's percentage was calculated in each communication: [(amplitude SAP digit III/amplitude SAP digit IV) × 100]. Results Ulnar-median nerves communication (Berrettini's branch) was found in 37 hands (10.95%), with a female gender predominance. Bilaterality percentage was low (1.78%). Most communications encountered had a Berretini's percentage between 11 and 50%. Some of them exceeded 100%. Conclusions Electromyographers should routinely search for this nerve communication, especially in those patients undergoing carpal tunnel syndrome or Dupuytren's contracture surgeries.

2009 ◽  
Vol 67 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Dante Guilherme Velasco Hardoim ◽  
Guilherme Bueno de Oliveira ◽  
João Aris Kouyoumdjian

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.


2006 ◽  
Vol 64 (3b) ◽  
pp. 747-749 ◽  
Author(s):  
João Aris Kouyoumdjian ◽  
Rogério Gayer Machado de Araújo

From 1989 to 2004, 3125 consecutive patients had electrodiagnosis of carpal tunnel syndrome (CTS); from these 43 cases (1.38%) were associated to manual milking; mean age was 44.9 years and 88.4% were male. The mean time in the milking profession was 247 months; the mean daily milking time was 146 minutes; symptoms referred at electrodiagnostic consultation had lasted on average 34 months, 83% were bilateral. The median sensory nerve conduction study was abnormal in 75.6% to the right and 66.7% to the left hand. The median nerve motor distal latency (MDL) was abnormal in 92.1% to the right and in 80.0% to the left hand. There were no differences between right and left for all electrophysiological parameters. In CTS related to manual milking most cases were men, with the MDL more affected than the sensory distal latencies and the electrophysiological abnormalities were found to be symmetric. Manual milking could be a natural model for occupational CTS. In contrast to idiopathic CTS, there was a greater involvement of motor fascicles; this finding is remarkable for CTS.


Hand ◽  
2012 ◽  
Vol 7 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Paul J. Jenkins ◽  
Andrew D. Duckworth ◽  
Adam C. Watts ◽  
Jane E. McEachan

Background The purpose of our study was to determine the rate of carpal tunnel decompression (CTD) following local corticosteroid injection for carpal tunnel syndrome (CTS), as well as identifying predictors of requiring further intervention and eventual decompression. Methods All patients diagnosed with CTS in our unit over a 6-year period were prospectively assessed. Patients were diagnosed using a combination of clinical presentation and nerve conduction studies. Patients were managed with open carpal tunnel decompression or corticosteroid injection. There were 1,564 consecutive patients diagnosed with CTS over the study period, of whom 824 (53%) underwent a corticosteroid injection as their primary treatment. We performed a survivorship analysis of these patients and used Kaplan–Meier survivorship methodology to determine the 5-year rate of re-intervention. Risk factors for re-intervention were also determined. Results The overall 5-year Kaplan–Meier rate of secondary CTD was 15% at 1 year and 33% at 5 years. The need for secondary CTD was independently associated with female gender, diabetes mellitus and positive nerve conduction studies at diagnosis. Conclusions Steroid injection is an appropriate treatment in carefully selected patients. Those who are female, diabetic and have neurophysiological confirmation of diagnosis have the highest risk of relapse. These results may be used to guide initial treatment and counsel patients about the risk relapse.


Author(s):  
Merve Nalbant ◽  
Oya Ümit Yemişci ◽  
Selin Özen ◽  
Şehnaz Tezcan

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.


2018 ◽  
Vol 5 (1) ◽  
pp. 1923-1930 ◽  
Author(s):  
Reza Sabet ◽  
Karamatollah Rahmanian ◽  
Abdolreza Sotoodeh Jahromi ◽  
Abdolhossein Madani

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.


2014 ◽  
Vol 35 (3) ◽  
pp. 543-552 ◽  
Author(s):  
Parvin Raji ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Bijan Forogh ◽  
Scott Hasson

Author(s):  
Riccardo Marvulli ◽  
Giancarlo Ianieri ◽  
Grazia Devenuto ◽  
Marta Falcicchio ◽  
Giulia A. Gallo ◽  
...  

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.


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