Peripheral nerve dysfunction and its correlation to interleukin-6 level in obese patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mary Fayez Francis ◽  
Mona Mahmoud Arafa ◽  
Irene Raouf Amin ◽  
Manal Samier Ahmad
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Interleukin 6 ◽  
Nerve Conduction ◽  
Obese Group ◽  
Control Group ◽  
Obese Patients ◽  
Posterior Tibial ◽  
Significant Difference

Abstract Background Obesity is now a worldwide health problem that predisposes to development of numerous complications, one of which is peripheral neuropathy (PN). Elevated interleukin-6 (IL-6) cytokine levels associating the chronic inflammatory state in obesity is thought to play a major role in obesity complications. Methods We conducted a Cross-sectional study on 30 obese patients and 10 matched healthy lean controls. All participants were subjected to full history taking, neurological examination, motor and sensory peripheral nerve conduction studies (NCS). Serum IL-6 levels were assessed using a commercially available ELISA. Laboratory investigations such as glycated haemoglobin, thyroid profile, liver and kidney function tests were done to exclude other known causes of PN. Results Radial, Posterior Tibial and Peroneal nerves had statistically significantly lower motor amplitudes in obese groups compared to control group. Sensory amplitudes of Median nerve showed statistically significant lower values in obese group with PN compared to control group. Conduction velocities (CV) of Ulnar nerve (motor and sensory) and sensory Median nerve showed statistically significant lower CVs in the obese group with PN compared to obese group without PN. Motor Ulnar nerve CV showed highly statistically significant higher velocities in the obese group without PN compared to control group. Posterior Tibial nerve distal motor latencies and Sensory nerve peak latencies of Median nerve had statistically significant higher values in obese group with PN compared to obese group without PN while statistically significant lower sensory peak latencies of Radial nerve were found in obese group without PN compared to control group. Regarding serum IL-6 levels, highly statistically significant higher levels were found in either obese groups when compared to the control group while no statistical significant difference was present between both obese groups and no correlation was found between serum IL-6 and NCS parameters in obese group with PN. Conclusion Our study revealed that despite only 6.667% of our non diabetic obese patients complained of symptoms of PN, by NCS 66.67% of patients were found to have electrophysiological evidence of PN while the remaining 33.33% of patients showed no evidence of PN and no correlation was found between serum IL-6 levels and nerve conduction parameters changes in obese patients diagnosed with PN.

scholarly journals Reference Values of Sensory and Motor Nerve Conduction for Patients of a Fourth Level Hospital in Bogotá, Colombia

2020 ◽  
Vol 61 (4) ◽  
Author(s):  
Carolina García Alfonso ◽  
Nancy Molina ◽  
Sonia Patricia Millán Pérez
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Conduction Velocity ◽  
Nerve Conduction ◽  
Peroneal Nerve ◽  
Tibial Nerve ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Motor Nerve Conduction ◽  
Significant Difference

Objective: To establish normal values of motor and sensory nerve conductions and late responses for the electrodiagnostic laboratory of the hospital universitario San Ignacio. Materials and Methods: Sensory and motor nerve conduction studies were performed on 77 healthy volunteers between 18 and 65 years old, for a total of 154 analyzes, using a standardized technique for measurement. Results: Motor nerve conduction. For the median nerve the latency ≤4.2ms, amplitude ≥3.1mV and conduction velocity ≥50.8m/s. In the ulnar nerve the latency ≤3.6ms, amplitude ≥4.6mV and conduction velocity ≥49m/s. Tibial nerve latency ≤4.4ms, amplitude ≥5mV and conduction velocity ≥41m/s. Peroneal nerve latency ≤4.8ms, amplitude ≥1.6mV and conduction velocity ≥42m/s. Sensory nerve conduction. For the median nerve the latency ≤2.8ms and conduction velocity ≥45m/s. In the ulnar nerve the latency ≤2.7ms and conduction velocity ≥46m/s. Sural nerve latency ≤2.2ms and conduction velocity ≥41m/s. A Shapiro Wilk test was performed, finding that the amplitude parameters for sensory nerve conductions did not follow a normal distribution, so percentile analysis was performed. Only sex showed a statistically significant difference for the parameters of tibial nerve amplitude (p = 0.0099) being greater in women, and latency of the peroneal nerve (p = 0.0091) being greater in men. Conclusion: Normal parameters were established for motor and sensory nerve conductions and late responses for the electrodiagnostic laboratory of the hospital universitario San Ignacio, which mostly correlate with the current reference data, with certain differences that could be related with height and sex, however, additional studies are required to establish this difference.

scholarly journals Ring Finger Sensory Latency Difference in the Diagnosis and Treatment of Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Qingping Wang ◽  
Hong Chu ◽  
Hongyang Wang ◽  
Yan Jin ◽  
Xiaoquan Zhao ◽  
...  
Keyword(s):  
Action Potential ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Ring Finger ◽  
Control Group ◽  
Latency Difference ◽  
Significant Difference ◽  
Sensory Action ◽  
Tunnel Syndrome ◽  
Sensory Latency

Abstract Objective: To explore the evaluation value of the sensitivity of the median/ulnar nerve sensory latency difference in the diagnosis of carpal tunnel syndrome and the evaluation value of severity.Methods: 122 patients with CTS and 42 normal controls were collected from the department of Neurology in Renmin Hospital of Wuhan University from July 2019 to January 2021. Electrophysiological tests were performed on the CTS patients group and the control group. The distal latency of the sensory nerve action potential (SNAP) of the median nerve and the ulnar nerve of the two groups was recorded. According to electrophysiological results，the patients were divided into three grades: mild, moderate and severe, the sensitivity of the nerve sensory action potential distal latency (SDL) to the diagnosis of CTS patients were analyzed, and the relationship with the severity of CTS was analyzed.Results: ①There were significant differences between the median nerve sensory action potential distal latency (MSDL) of 179 affected hands and the control group; And median and ulnar sensory latency difference to ring finger (MUD) was significantly different from the control group; But ulnar nerve sensory action potential distal latency （USDL） was not significantly different from the control group (P=0.182). When the cutoff value of MSDL is 2.465ms, the sensitivity is 85.5% and the specificity is 90.4%; when the cutoff value of MUD is 0.38ms, the sensitivity is 100% and the specificity is 100%. ②In the mild, moderate, severe and control group, there was no significant difference in USDL between all the groups (P=0.56)a; between the control group and the mild group, moderate group, and severe group, and between the mild and moderate, significant differences were found in the MSDL and MUD. No significant difference between mild and severe (P=0.66), moderate and severe (P=1.00). ③ MSDL and MUD are correlated with the severity of CTS. There is no correlation between USDL and CTS severity.Conclusion: The ulnar nerve is not damaged in CTS; a smaller MSDL can reflect median nerve damage, which is beneficial to the early diagnosis of CTS; MUD is more sensitive than MSDL in diagnosing CTS; MUD is correlated with severity, which is beneficial to pain for patients who are more sensitive and cannot tolerate electrical stimulation, perhaps only measuring MUD can reflect the severity, relieve the patient's pain, and can be used to evaluate the therapeutic effect.

scholarly journals Asymptomatic Neuropathy in Recently Diagnosed Diabetic Patients: Electrophysiological Evaluation

2014 ◽  
Vol 30 (1) ◽  
pp. 16-22
Author(s):  
Abu Saleh Md Badrul Hasan ◽  
Biplob Kumar Roy ◽  
Kazi Giasuddin Ahmed ◽  
Md Rafiqul Islam ◽  
AKM Anwaullah ◽  
...  
Keyword(s):  
Diabetic Neuropathy ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Motor Nerve ◽  
Sensory Nerves ◽  
Case Group ◽  
Diabetic Patients ◽  
Significant Difference ◽  
And Control

Aim & background: As significant electrophysiological changes are found in asymptomatic neuropathy in diabetes mellitus and electrophysiological studies of nerve conduction velocity are our most sensitive tools to quantify early abnormalities, therefore, we tried to find out status of asymptomatic peripheral nerve dysfunction in recently diagnosed diabetic patients in Bangladesh perspective. Method :This study was carried out at BSMMU and BIRDEM during November 2005 and April 2006. The study included 60 subjects, 30 recently diagnosed diabetic subjects (14 male, 16 female). None had neuropathic symptoms or signs. All cases were selected randomly diagnosed by ADA criteria accepted by WHO. Thirty healthy controls with mean age comparable to that of diabetic subject were selected from the friends of the subjects and patients attending neurology outdoor of BSMMU. Result:Findings (mean±SD) were (case and control, respectively): Tibial nerve, DML 4.05±0.81 and 3.84±0.70 msec (P>0.10), CMAP 16.90±5.14 and 19.49±4.73 mV (P<0.05), MCV 45.43±4.55 and 48.24±4.72 m/ s (P<0.05), and F latency 45.09±12.43 and 42.50±8.93 msec (P>0.10); peroneal nerve, DML 4.12±1.10 and 4.03±0.67 msec (P>0.50), CMAP 5.80±2.89 and 6.97±1.79 mV (P>0.05), MCV 43.10±8.89 and 48.27±3.56 m/s (P<0.01), and F latency 50.27±10.81 and 41.32±3.05 msec (P<0.001); median nerve, DML 3.57±0.46 and 3.55±0.52 msec (P>0.50), CMAP 16.33±4.24 and 17.84±3.73 mV (P>0.10) and MCV 55.16±5.33 and 57.70±4.33 m/s (P<0.05), and F latency 25.08±5.28 and 24.39±4.83 msec (P>0.50); and ulnar nerve DML 2.57±0.33 an 3.17±0.61 msec (P<0.001), CMAP 14.65±3.32 and 17.29±6.83 mV (P>0.05), MCV 55.74±5.00 and 58.50±5.13 m/s (P<0.05), F latency 25.09±5.35 and 25.82±3.33 msec (P>0.50); sural nerve, DSL 2.46±0.68 and 3.12±0.45 msec (P<0.001), SNAP 19.44±10.25 and 25.32±7.88 ìV (P<0.05), SCV 49.95±10.22 and 52.46±3.96 m/s (P>0.10); median nerve, DSL 2.52±0.39 and 2.77±0.49 msec (P<0.05), SNAP 30.23±12.79 and 31.69±11.02 ìV (P>0.50), and SCV 56.90±6.77 and 57.41±5.85 m/s (P>0.50); and ulnar nerve, DSL 2.03±0.39 and 2.48±0.49 msec (P<0.001), SNAP 29.30±14.36 and 30.72±10.76 ìV (P>0.50), and SCV 60.96±8.38 and 57.93±7.15 m/s (P>0.10). Mean (±SD) HbA1c was significantly high (P<0.001) in case group (7.10±0.80%) compared to control (5.51±0.65%). Mean (±SD) SGPT showed no significant difference between case (36.10±13.02 u/L) and control (36.20±7.94 u/L). Similarly, mean (±SD) total cholesterol also showed no significant difference between case (201.57±37.56 mg/dl) and control (191.00±17.17 mg/dl). Conclusion: Motor nerve conduction parameters are affected more than sensory nerves and F-wave latencies are more frequently and early involved in these subjects. Abnormalities on nerve conduction was started in the feet rather than the hands.Clinical spectrum of diabetic neuropathy is variable and may be asymptomatic, but once established as polyneuropathy, it is irreversible and may finally be disabling. Early detection of diabetic neuropathy is one of the major goals in the management of diabetes since timely intervention may substantially reduce mortality and morbidity. Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 16-22

Fascicular Ratio Pilot Study: High-Resolution Neurosonography—A Possible Tool for Quantitative Assessment of Traumatic Peripheral Nerve Lesions Before and After Nerve Surgery

Neurosurgery ◽  
2018 ◽  
Vol 85 (3) ◽  
pp. 415-422 ◽  
Author(s):  
Christian Heinen ◽  
Patrick Dömer ◽  
Thomas Schmidt ◽  
Bettina Kewitz ◽  
Ulrike Janssen-Bienhold ◽  
...  
Keyword(s):  
High Resolution ◽  
Peripheral Nerve ◽  
Quantitative Assessment ◽  
Control Group ◽  
Structural Reorganization ◽  
Magnetic Resonance Neurography ◽  
Nerve Lesions ◽  
Peripheral Nerve Lesions ◽  
Significant Difference ◽  
Nerve Surgery

Abstract BACKGROUND Clinical and electrophysiological assessments prevail in evaluation of traumatic nerve lesions and their regeneration following nerve surgery in humans. Recently, high-resolution neurosonography (HRNS) and magnetic resonance neurography have gained significant importance in peripheral nerve imaging. The use of the grey-scale-based “fascicular ratio” (FR) was established using both modalities allowing for quantitative assessment. OBJECTIVE To find out whether FR using HRNS can assess nerve trauma and structural reorganization in correlation to postoperative clinical development. METHODS Retrospectively, 16 patients with operated traumatic peripheral nerve lesions were included. The control group consisted of 6 healthy volunteers. All imaging was performed with a 15 to 6 MHz ultrasound probe (SonoSite X-Porte; Fujifilm, Tokyo, Japan). FR was calculated using Fiji (兠) on 8-bit-images (“MaxEntropy” using “Auto-Threshold” plug-in). RESULTS Thirteen of 16 patients required autologous nerve grafting and 3 of 16 extra-intraneural neurolysis. There was no statistical difference between the FR of nonaffected patients’ nerve portion with 43.48% and controls with FR 48.12%. The neuromatous nerve portion in grafted patients differed significantly with 85.05%. Postoperatively, FR values returned to normal with a mean of 39.33%. In the neurolyzed patients, FR in the affected portion was 78.54%. After neurolysis, FR returned to healthy values (50.79%). Ten of 16 patients showed clinical reinnervation. CONCLUSION To our best knowledge, this is the first description of FR using HRNS for quantitative assessment of nerve damage and postoperative structural reorganization. Our results show a significant difference in healthy vs lesioned nerves and a change in recovering nerve portions towards a more “physiological” ratio. Further evaluation in larger patient groups is required.

The influence of obesity on functional outcome and quality of life after total knee arthroplasty

2018 ◽  
Vol 100-B (5) ◽  
pp. 579-583 ◽  
Author(s):  
S. Xu ◽  
J. Y. Chen ◽  
N. N. Lo ◽  
S. L. Chia ◽  
D. K. J. Tay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Obese Group ◽  
Control Group ◽  
Obese Patients ◽  
Knee Score ◽  
Total Knee

AimsThis study investigated the influence of body mass index (BMI) on patients’ function and quality of life ten years after total knee arthroplasty (TKA).Patients and MethodsA total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: < 30 kg/m2(control) and ≥ 30 kg/m2(obese). Functional outcome was assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey.ResultsPatients in the obese group underwent TKA at a younger age (mean, 63.0 years, sd 8.0) compared with the control group (mean, 65.6 years, sd 7.6; p = 0.03). Preoperatively, both groups had comparable functional and quality-of-life scores. Ten years postoperatively, the control group had significantly higher OKS and MCS compared with the obese group (OKS, mean 18 (sd 5) vs mean 22 (sd 10), p = 0.03; MCS, mean 56 (sd 10) vs mean 50 (sd 11), p = 0.01). After applying multiple linear regression with the various outcomes scores as dependent variables and age, gender, and Charlson Comorbidity Index as independent variables, there was a clear association between obesity and poorer outcome in KSFS, OKS, and MCS at ten years postoperatively (p < 0.01 in both KSFS and OKS, and p = 0.03 in MCS). Both groups had a high satisfaction rate (97.8% in the control group vs 87.9% in the obese group, p = 0.11) and fulfillment of expectations at ten years (98.9% in the control group vs 100% in the obese group, p = 0.32).ConclusionAlthough both obese and non-obese patients have significant improvements in function and quality of life postoperatively, obese patients tend to have smaller improvements in the OKS and MCS ten years postoperatively. It is important to counsel patients on the importance of weight management to achieve a more sustained outcome after TKA. Cite this article: Bone Joint J 2018;100-B:579–83.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

Central and Peripheral Nerve Conduction in Thyroid Dysfunction: The Influence of l-Thyroxine Therapy Compared with Warming upon the Conduction Abnormalities of Primary Hypothyroidism

1983 ◽  
Vol 64 (6) ◽  
pp. 617-622 ◽  
Author(s):  
R. J. Abbott ◽  
B. P. O'Malley ◽  
D. B. Barnett ◽  
L. Timson ◽  
F. D. Rosenthal
Keyword(s):  
Peripheral Nerve ◽  
Nerve Conduction ◽  
Primary Hypothyroidism ◽  
Control Group ◽  
Conduction Delay ◽  
Evoked Responses ◽  
Visual Evoked Responses ◽  
Thyroxine Therapy ◽  
Hypothyroid Patients ◽  
Visual Evoked

1. The latencies of the visual evoked responses, indices of central nerve conduction, and peripheral nerve conduction were slowed in patients with primary hypothyroidism compared with controls. 2. in thyrotoxic patients, there was no change in the latencies of the visual evoked responses and peripheral nerve conduction compared with the control group. 3. The abnormalities seen in hypothyroidism were reversed by L-thyroxine therapy. 4. Warming untreated hypothyroid patients significantly improved both central and peripheral nerve conduction. 5. The conduction delay found in hypothyroidism is to a large extent dependent upon a subnormal body temperature.

scholarly journals The Influence Of Obesity in Stage IIB Posterior Tibial Tendon Dysfunction Corrective Surgery

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0044
Author(s):  
Amila Silva ◽  
Inderjeet Rikhraj
Keyword(s):  
Clinical Outcomes ◽  
Statistical Significance ◽  
Obese Group ◽  
Control Group ◽  
Posterior Tibial Tendon ◽  
Corrective Surgery ◽  
Posterior Tibial Tendon Dysfunction ◽  
Repeat Surgery ◽  
Posterior Tibial ◽  
Hind Foot

Category: Hindfoot Introduction/Purpose: In the western population prevalence of posterior tibial tendon dysfunction (PTTD) is said to be 3.3% and it is one of the most commonly undiagnosed foot and ankle pathologies. Stage IIB disease according to Johnson and Strom criteria is managed surgically and there are literature demonstrating good clinical outcomes. Obesity being a global epidemic it affects the patient both biomechanically and biochemically. Aim of the study was to investigate the influence of obesity on functional outcome scores, incidence of postoperative surgical site infection (SSI), and repeat surgery after corrective surgery for stage IIB posterior tibial tendon dysfunction (PTTD). Methods: Between January 2007 and December 2013, 102 patients who underwent corrective surgery for stage IIB PTTD at a tertiary hospital were evaluated. We categorized the group with a BMI less than 30 kg/m as control and the group with BMI more than 30 kg/m as obese. The patients were prospectively followed for 2 years. AOFAS mid foot and hind foot scores, mid foot and hind foot VAS scores, SF36 physical and mental function scores were measured pre-operative, post-operative 6 months and post-operative 24 months. SPSS was used for statistical analysis. P value <0.05 was considered as a significant value. Results: 19.6 percent of our study population was obese, there were 38 males and 64 females. The average age of the population was 44.3years and the average BMI for the population was 28.78kg/m2. Clinical outcomes are as follows SF36 physical function score demonstrated statistical significance (p=0.0001, CI -22.20 to -9.80), AOFAS midfoot scores (p=0.82, CI -9.55 to 7.56), AOFAS hindfoot scores (p=0.23, CI -10.60 to 2.60), Midfoot Visual Analogue Scores (p=0.54, CI 0.31 to 0.76), Hindfoot Visual Analogue Scores (p=0.45, CI 0.21 to 0.68) and SF36 mental health scores (p=0.99, CI -5.76 to 7.74) did not demonstrate any significance (6%) in the control group and 10% in the obese group required repeated surgery for complications. Conclusion: Both groups of patients who underwent corrective surgery for stage IIB pttd demonstrated good functional outcomes but there was a significantly higher risk of repeat surgery in the obese group. Obese patients should not be excluded from stage IIB PTTD corrective surgery but patients should be counselled of the higher risk percentage.

Peripheral Nerve Ultrasound and Short-Segment Nerve Conduction Studies Before and After Ulnar Nerve Decompression

2016 ◽  
Vol 35 (6) ◽  
pp. 1367-1368
Author(s):  
Jonathan K. Smith ◽  
Matthew E. Miller ◽  
David E. Reece ◽  
Yin-Ting Chen ◽  
Mark E. Landau
Keyword(s):  
Peripheral Nerve ◽  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Nerve Ultrasound ◽  
Short Segment ◽  
Nerve Decompression ◽  
Before And After

Ulnar and Median Nerve Abnormalities in Carpal Tunnel Syndrome

2020 ◽  
Vol 22 (5) ◽  
pp. 313-322
Author(s):  
Filip Georgiew ◽  
Andrzej Maciejczak ◽  
Jakub Florek ◽  
Ireneusz Kotela
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Control Group ◽  
Conduction Disturbances ◽  
Tunnel Syndrome ◽  
Sensory Fibers ◽  
American Academy Of Neurology

Background. Nerve compression underlying carpal tunnel syndrome (CTS) results in an increase in the threshold of superficial sensation in the area supplied by the median nerve, which is a mixed nerve dominated by sensory fibres. The distribution of sensory symptoms is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment at wrist level is still unclear. Patho­logical processes leading to median neuropathy in CTS may affect ulnar nerve motor and sensory fibers in the Guyon canal. This may explain the extra-median spread of sensory symptoms in CTS patients. Material and methods. The study involved 88 patients (104 hands), with 70 women (83 hands) and 18 men (21 hands) aged between 25 and 77 years. 50 age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. The diagnosis of carpal tunnel syndrome was made according to the criteria of the American Academy of Neurology 1993 guidelines. Based on the results of an ENG trace evaluating the degree of conduction disturbances in the median nerve, the patients were classified to one of three severity subgroups. The threshold of sensory excitability to pulsed current was determined in a test with single 100 ms rectangular pulses. Conclusions. 1. The threshold of sensation in the fingers innervated by the median and ulnar nerve is significantly lon­ger in patients with CTS than in controls. 2. Surgical treatment decreases the threshold of sensation in the fingers innervated by the median nerve. 3. Surgical treatment does not decrease the threshold of sensation in the fingers innervated by the ul­nar nerve. 4. The preoperative and postoperative threshold of sensation in the fingers innervated by the median and ulnar nerve is significantly longer in patients with severe carpal tunnel than in mild and moderate cases.

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