scholarly journals Ultrasonographic and electrophysiological outcomes of carpal tunnel syndrome treated with low-level laser therapy: A double-blind, prospective, randomized, sham-controlled study

2021 ◽  
Author(s):  
Merve Nalbant ◽  
Oya Ümit Yemişci ◽  
Selin Özen ◽  
Şehnaz Tezcan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Therapy Group ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Low Level Laser Therapy ◽  
Level Laser ◽  
Tunnel Syndrome

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.

scholarly journals Effect of Gabapentin on nerve conduction studies in carpal tunnel syndrome

2018 ◽  
Vol 5 (1) ◽  
pp. 1923-1930 ◽  
Author(s):  
Reza Sabet ◽  
Karamatollah Rahmanian ◽  
Abdolreza Sotoodeh Jahromi ◽  
Abdolhossein Madani
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Quasi Experimental ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B

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.

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.

scholarly journals Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

2021 ◽  
Vol 8 (11) ◽  
pp. 181
Author(s):  
Konstantinos I. Tsamis ◽  
Prokopis Kontogiannis ◽  
Ioannis Gourgiotis ◽  
Stefanos Ntabos ◽  
Ioannis Sarmas ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Automatic Detection ◽  
Nerve Conduction Studies ◽  
Machine Learning Techniques ◽  
Tunnel Syndrome

Recent literature has revealed a long discussion about the importance and necessity of nerve conduction studies in carpal tunnel syndrome management. The purpose of this study was to investigate the possibility of automatic detection, based on electrodiagnostic features, for the median nerve mononeuropathy and decision making about carpal tunnel syndrome. The study included 38 volunteers, examined prospectively. The purpose was to investigate the possibility of automatically detecting the median nerve mononeuropathy based on common electrodiagnostic criteria, used in everyday clinical practice, as well as new features selected based on physiology and mathematics. Machine learning techniques were used to combine the examined characteristics for a stable and accurate diagnosis. Automatic electrodiagnosis reached an accuracy of 95% compared to the standard neurophysiological diagnosis of the physicians with nerve conduction studies and 89% compared to the clinical diagnosis. The results show that the automatic detection of carpal tunnel syndrome is possible and can be employed in decision making, excluding human error. It is also shown that the novel features investigated can be used for the detection of the syndrome, complementary to the commonly used ones, increasing the accuracy of the method.

Comparison of Borderline Ultrasound and Nerve Conduction Studies for Carpal Tunnel Syndrome

Hand ◽  
2020 ◽  
pp. 155894472096496
Author(s):  
Cory Demino ◽  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Threshold Values ◽  
Cutoff Values ◽  
Number Of Patients ◽  
Tunnel Syndrome ◽  
Median Neuropathy

Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

Case 14

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Clinical Practice ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Case Presentation ◽  
Peripheral Polyneuropathy ◽  
Tunnel Syndrome ◽  
Internal Comparison

Carpal tunnel syndrome is the most common entrapment neuropathy encountered in clinical practice. It is also the most common reason for referral to the electromyography laboratory. The anatomy of the median nerve and the carpal tunnel are outlined in details in this case presentation. The recommended nerve conduction studies needed to make a diagnosis are outlined. This includes internal comparison nerve conduction studies in which the median nerve is compared to a neighboring nerve such as ulnar or radial nerves, as well as the inching studies across the carpal tunnel. Finally, special situations are emphasized including severe carpal tunnel syndrome, carpal tunnel syndrome associated with peripheral polyneuropathy, carpal tunnel syndrome in the presence of Martin–Gruber anastomosis, and carpal tunnel syndrome during pregnancy.

scholarly journals Carpal tunnel syndrome and manual milking: nerve conduction studies in 43 cases

2006 ◽  
Vol 64 (3b) ◽  
pp. 747-749 ◽  
Author(s):  
João Aris Kouyoumdjian ◽  
Rogério Gayer Machado de Araújo
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Left Hand ◽  
Tunnel Syndrome ◽  
The Mean ◽  
The Right ◽  
Mean Time

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.

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