scholarly journals Cooling modifies mixed median and ulnar palmar studies in carpal tunnel syndrome

2007 ◽  
Vol 65 (3b) ◽  
pp. 779-782 ◽  
Author(s):  
Rogério Gayer Machado de Araújo ◽  
João Aris Kouyoumdjian

Temperature is an important and common variable that modifies nerve conduction study parameters in practice. Here we compare the effect of cooling on the mixed palmar median to ulnar negative peak-latency difference (PMU) in electrodiagnosis of carpal tunnel syndrome (CTS). Controls were 22 subjects (19 women, mean age 42.1 years, 44 hands). Patients were diagnosed with mild symptomatic CTS (25 women, mean age 46.6 years, 34 hands). PMU was obtained at the usual temperature, >32°C, and after wrist/hand cooling to <27°C in ice water. After cooling, there was a significantly greater increase in PMU and mixed ulnar palmar latency in patients versus controls. We concluded that cooling significantly modifies the PMU. We propose that the latencies of compressed nerve overreact to cooling and that this response could be a useful tool for incipient CTS electrodiagnosis. There was a significant latency overreaction of the ulnar nerve to cooling in CTS patients. We hypothesize that subclinical ulnar nerve compression is associated with CTS.

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Brandon Shulman ◽  
Jonathan Bekisz ◽  
Christopher Lopez ◽  
Samantha Maliha ◽  
Siddharth Mahure ◽  
...  

Background: Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment. Results: In the SPARCS database, the percentage of patients surgically treated for concomitant UNE and CTS steadily increased from 23% in 2003 to 45% in 2014. At our institution, 50 of 222 patients (23%) surgically treated for UNE underwent concomitant carpal tunnel releases. For concomitantly treated patients, 94% had examinations consistent with UNE and CTS, 87% of patients had median nerve compression on electrodiagnostic tests, and 72% of patients had UNE on electrodiagnostic tests. Conclusions: Most patients concomitantly treated for UNE and CTS have objective findings of both conditions. At least one-fourth of patients indicated for operative ulnar nerve release also require a carpal tunnel release—far beyond the prevalence of CTS in the general population. A diagnosis of UNE merits a comprehensive workup by the treating surgeon and a high suspicion for concomitant median nerve compression.


Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher

Neuroanatomy 298Examination of the nerves of the upper limb 300Clinical assessment 304Neurophysiology tests 306Nerve injury 310Compression neuropathy 314Carpal tunnel syndrome 315Proximal compression of the median nerve 318Anterior interosseous nerve syndrome 319Ulnar nerve compression at the elbow ...


2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-449-ONS-457
Author(s):  
Stephen M. Russell ◽  
David G. Kline

Abstract The goal of this two-part review is to discuss peripheral nerve surgery complications, along with the techniques and principles used to prevent them. In this second article, we concentrate on injuries, tumors, and entrapment of nerves in the extremities, including carpal tunnel syndrome and ulnar nerve compression at the elbow.


2021 ◽  
pp. 117-120
Author(s):  
Padmapriyadarsini V ◽  
Navin K ◽  
Abdul Gafoor S ◽  
Chitra G

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment syndrome of median nerve causing frequent disability especially among working populations. Boston Carpal Tunnel Questionnaire and Electrophysiological study helps in detecting and aiding in the diagnosis of CTS and helps in determining level of improvement after surgical release of carpal tunnel. OBJECTIVES: To assess functional outcome of patients with Carpal Tunnel Syndrome after surgery as assessed by Boston Carpel Tunnel Questionnaire and Electrophysiological study. METHODS: A prospective observational study conducted over a period of one year (January 2017 to January 2018). The study was conducted among consecutive 31 electrophysiological conrmed carpal tunnel syndrome attending the outpatient department of Physical Medicine and Rehabilitation, Government Medical College, Thiruvananthapuram. All patients underwent open carpal tunnel release. Functional outcome was assessed using Boston Carpal Tunnel Questionnaire (BCTQ) both preoperatively and at interval of 3 weeks, 6weeks and 3 months postoperatively. Electrophysiological study assessed using nerve conduction study both preoperatively and 3 weeks post operatively. Data was entered in Microsoft excel and analyzed using SPSS statistical software. RESULTS: The study involves 31 conrmed cases of Carpal tunnel syndrome patients. Mean Boston Carpal Tunnel Questionnaire (BCTQ) score preoperatively was 58.52 ± 12.73 which was markedly improved postoperatively at 3weeks with mean score of 29.77±6.68. At 6 weeks and 3 month follow up period it was reduced respectively to mean score of 23.94±4.23 and 22.94±4.62. Preoperative NCS shows decreased conduction velocity with mean nerve sensory velocity (NSV) score 21.51±8.19 and mean nerve motor velocity (NMV) score of 20.72±8.81 which statistically improved following surgery with mean NSV score of 32.04±9.01 and mean NML score of 33.78±8.1. Correlation between pre- and post-operative BCTQ and NCS parameters shows positive correlation with latency and negative correlation with amplitude and conduction velocity. Increased latency and decreased conduction velocity associated with higher BCTQ score with signicant 'p' value (p<0.05). CONCLUSION: There is statistically signicant improvement of functional outcome following carpal tunnel release surgery assessed through Boston Carpal Tunnel Questionnaire and Electrophysiological ndings


2019 ◽  
Vol 45 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Samuel P. Mackenzie ◽  
Oliver D. Stone ◽  
Paul J. Jenkins ◽  
Nicholas D. Clement ◽  
Iain R. Murray ◽  
...  

Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management. Preoperative QuickDASH scores were comparable in both groups (58 vs 54.8). However, there were significant differences between the normal and abnormal nerve conduction study groups in the QuickDASH at 1 year (34.9 vs 21.5) and change in QuickDASH postoperatively (23.1 vs 33.4). Patients with normal nerve conduction studies had comparable preoperative disability scores compared with those with abnormal studies. Although they had a significant improvement in QuickDASH at 1 year, this was significantly less than those with abnormal nerve conduction studies. Level of evidence: III


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