Carpal tunnel syndrome in the elderly: nerve conduction parameters

Abstract

Objective: To establish nerve conduction parameters for carpal tunnel syndrome (CTS) electrodiagnosis in the elderly. Method: Thirty healthy subjects (65-86 years), 9 male and 21 female, were studied. Routine median and ulnar sensory and motor nerve conduction studies, median mixed palmar latency, comparative latency techniques median to ulnar (sensory, mixed and motor lumbrical-interossei), median to radial (sensory), and combined sensory index (CSI) were performed in both hands. results: The upper limits of normality (97.5%) were: median sensory distal latency 3.80 ms (14 cm); median motor distal latency 4.30 ms (8 cm); median palmar latency 2.45 ms (8 cm); lumbrical-interossei latency difference 0.60 ms (8 cm); comparative median to radial 0.95 ms (10 cm); comparative median to ulnar 0.95 ms (14 cm); comparative palmar median to ulnar 0.50 ms (8 cm); and CSI 2.20 ms. Sensory and mixed latencies were measured at peak. conclusion: Our results establish new nerve conduction parameters for mild CTS electrodiagnosis in the elderly and will be helpful to reduce the number of false positive cases in this age. Key words: carpal tunnel syndrome, median nerve, nerve conduction studies, normative study, aging.síndrome do túnel do carpo em idosos: parâmetros de condução nervosa resuMO Objetivo: Estabelecer parâmetros de condução nervosa para o eletrodiagnóstico da síndrome do túnel do carpo (STC) em idosos. Método: Foram estudadas 30 pessoas idosas (65-86 anos) saudáveis. Foi realizado estudo de condução nervosa sensitiva e motora rotineira dos nervos mediano e ulnar, latência palmar mista do mediano, técnicas de comparação de latências mediano-ulnar (sensitivo, misto e motor lumbrical-interósseo) e mediano-radial (sensitivo) e índice sensitivo combinado (ISC) em ambas as mãos. resultados: Os limites superiores de normalidade, 97,5% foram: latência distal sensitiva do mediano 3,80 ms (14 cm); latência distal motora do mediano 4,30 ms (8 cm), latência palmar do mediano 2,45 ms (8 cm), diferença de latência lumbrical-interósseo 0,60 ms (8 cm), comparação mediano-radial 0,95 ms (10 cm), comparação mediano-ulnar 0,95 ms (14 cm), comparação mediano-ulnar palmar 0,50 ms (8 cm) e ISC 2,20 ms. As latências sensitivas e mistas foram medidas no pico. conclusão: Nossos resultados estabelecem novos valores de condução nervosa para o eletrodiagnóstico da STC leve em idosos. Palavras-chave: síndrome do túnel do carpo, nervo mediano, estudo de condução nervosa, valores de normalidade, envelhecimento. CorrespondenceJoão Aris Kouyoumdjian R. Luiz Antônio da Silveira 1661 15025-020 São José do Rio Preto SP -Brasil

Ring finger sensory latency difference in the diagnosis and treatment of carpal tunnel syndrome

“…A simple increase in MSDL does not indicate that CTS should be diagnosed, but a comparison with the UN on the same hand and MUD calculation can provide better insight regarding the problem. Most of the previously reported MSDL cut-off values were between 2.7 and 3.8 ms (mostly around 3.7 ms), with a sensitivity of 67% ~ 90% and a specificity mostly above 90% [3, 14, 15,21,[23][24][25][26]. In our study, the sensitivity of MSDL for the diagnosis of CTS was 92.2% and the specificity was 99.4%, which were similar to the results of previous studies.…”

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

“…The simple prolongation of MSDL does not indicate that CTS can be diagnosed, but comparing with its own UN and calculating MUD can explain the problem better. Most of the previously reported MSDL cut-off values were between 2.7-3.8 ms, and more were around 3.7 ms, the sensitivity is 67%~90%, and the speci city is mostly greater than 90% (3,11,12,18,(20)(21)(22)(23). In our study, the sensitivity of MSDL to diagnose CTS was 85.5%, and the speci city was 90.4%, which was similar to the results of previous studies.…”