“…4). This was described as the ‘bactrian sign’ by Cassvan et al (1988), who considered this sign recorded in the thumb to intermediate stimulation of median and radial nerves at the wrist as the most sensitive sign (83.7% positivity) for the diagnosis of CTS.Fig. 4Differences between double peak potentials of different origin.…”
Section: Antidromic and Orthodromic Testing Of Carpal Tunnel Syndromementioning
confidence: 99%
“…However, using an intermediate electrode position for either stimulation (Cassvan et al, 1988) or recording (Valls-Sole and Llanas, 1988) saves time and discomfort to the patient because only one stimulus series is used, and gives rise to a convincing graphical evidence of the dysfunction in the median nerve with respect to the nerve with which it is compared (Fig. 4).…”
Section: Antidromic and Orthodromic Testing Of Carpal Tunnel Syndromementioning
HighlightsWe review orthodromic and antidromic testing of sensory conduction in median nerve.The effects of physical and physiological changes differ between the two techniques.Research studies may specifically demand one or the other technique.
“…4). This was described as the ‘bactrian sign’ by Cassvan et al (1988), who considered this sign recorded in the thumb to intermediate stimulation of median and radial nerves at the wrist as the most sensitive sign (83.7% positivity) for the diagnosis of CTS.Fig. 4Differences between double peak potentials of different origin.…”
Section: Antidromic and Orthodromic Testing Of Carpal Tunnel Syndromementioning
confidence: 99%
“…However, using an intermediate electrode position for either stimulation (Cassvan et al, 1988) or recording (Valls-Sole and Llanas, 1988) saves time and discomfort to the patient because only one stimulus series is used, and gives rise to a convincing graphical evidence of the dysfunction in the median nerve with respect to the nerve with which it is compared (Fig. 4).…”
Section: Antidromic and Orthodromic Testing Of Carpal Tunnel Syndromementioning
HighlightsWe review orthodromic and antidromic testing of sensory conduction in median nerve.The effects of physical and physiological changes differ between the two techniques.Research studies may specifically demand one or the other technique.
“…They have established that sensitivity and specificity of clinical investigation vary considerably (D'Arcy & McGee, 2000). As part of our research we decided to compare thermograms with electrodiagnostics, since the latter is considered the most specific, sensitive (over 90%), and objective test for CTS diagnostics (Cassvan et al, 1988;Hennessey & Johnson, 1996;Hilburn, 1996;Jackson & Clifford, 1989;Johnson, 1993;Lew et al, 2005;Seror, 1987). Rosenbaum and Ochoa warn that thermography cannot simply be equated with the CTS diagnostics, because it does not say much about the patophysiological basis of thermographic changes and entrapment, other than presenting changes in body temperature in a very precise and spectacular manner (Rosenbaum & Ochoa, 2002).…”
“…Rather than solely relying on the absolute value of a parameter, comparison of a value between two different nerves in the same patient is used in certain circumstances. For example, in patients being evaluated for carpal tunnel syndrome, comparison of the latencies between median and the ulnar or radial nerves may be used to identify very mild focal slowing in the distal segment of the median nerve (Cassvan et al, 1988;Meena et al, 2008). These nerve-to-nerve comparisons typically compare the latencies or conduction velocities, because the conduction times along segments of different nerves in a similar location in the limb should conduct at similar rates.…”
The pattern of findings on nerve conduction studies is an important component of an electrodiagnostic evaluation to assess for peripheral neuromuscular disorders. The aim of this study was to determine the extent to which a lower tibial compound muscle action potential (CMAP) amplitude compared with the peroneal CMAP amplitude is more indicative of specific neuromuscular disorders such as S1 radiculopathies, sciatic neuropathies, or peripheral neuropathies. The electromyographic (EMG) findings of 921 patients who had undergone an EMG of the lower extremity and in whom the EMG study was interpreted as normal or a single neuromuscular diagnosis was identified were retrospectively reviewed to determine the frequency of an absolutely lower tibial than peroneal CMAP amplitude. Thirty-five (7%) healthy subjects had a lower tibial than peroneal CMAP amplitude (i.e., the absolute value of the tibial CMAP was lower than the absolute value of the peroneal CMAP), despite both values being in normal range. The finding on nerve conduction study of an absolutely lower tibial than peroneal CMAP occurred in a significantly higher proportion of patients with a diffuse polyneuropathy (24%) and S1 radiculopathies (21%) compared with controls. The findings suggest that in subjects in whom lower extremity nerve conduction study demonstrates an absolutely lower tibial than peroneal CMAP amplitude, neuromuscular disorders such as a polyneuropathy or S1 radiculopathy should be considered.
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