Neurophysiologic Pattern and Severity Grading Scale of Carpal Tunnel Syndrome in Sudanese Patients

Background: Carpal Tunnel Syndrome (CTS) is a constellation of symptoms and signs caused by entrapment of the median nerve at the wrist. Nerve Conduction Study (NCS) serve as an objective supplementary modality in the diagnosis of CTS and is used for severity assessment with high degree of sensitivity and specificity. Severity assessment is a crucial step for defining prognosis of CTS. Methodology: The study was a hospital based observational cross sectional study and was conducted in the department of Neurology, DMCH on 50 patients with clinical diagnosis of CTS with electro-physiological confirmation from July, 2017 to June, 2019. Equal number of age and sex matched healthy people were included in the study. All the cases had clinical evaluation and standardized electrophysiological studies of upper limbs using the same protocol. Result: The mean age of CTS patients was 43.06 (±10.54) years and majority of the them were female (74%). In patients with CTS, electrophysiological study of median nerve revealed the following mean value MDL=5.98± 1.63 ms, SDL=4.24± 0.59 ms, CMAP = 6.16± 3.22mv, MNCV = 54.46± 6.76 m/s, SNAP = 11.65± 13.42 ìV, In Comparison to mild to moderate CTS other than CMAP, all other parameters have significant changes. In case of moderate to severe grade of CTS, all the parameters have significant changes. Amongst the 50 CTS patients, there was bilateral involvement in 21 (42%) and unilateral involvement in 29 (58%) patient. According to electrophysiological grading, 15 (21%) were in mild group; 35 (49%) were in moderate group and 21 (30%) were in severe group. According to the clinical grading, 31 (44%) were in mild group, 25 (35%) in moderate and 15 (21%) were in severe group. Conclusion: From this study it could be concluded that CTS is more common in female. Sensory symptoms and dominant (right) hand involvement were more common. NCS provides additional and independent objective evidence in the diagnosis and severity assessment of CTS patients. Assessment of severity in CTS patients is a crucial step for defining prognosis and therapeutic measures. J Dhaka Med Coll. 2021; 30(2) : 161-166

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“…Abdalla, S.F. et al (2017) in their study stated that out of 671 patients with CTS, paresthesia was reported by 339 patients (70%) 8 .…”

Section: Discussionmentioning

confidence: 95%

Electro-Physiological Pattern And Severity Grading of Carpal Tunnel Syndrome

Jahan¹,

Islam

Islam³

et al. 2023

J Dhaka Med Coll

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“…Aygül et al found a significant delay in F latencies with progressive disease in their study of 57 patients [ 14 ]. Another comprehensive investigation into subgroups revealed a decrease in F-wave conduction velocity, correlated with disease severity [ 15 ]. However, the latter study lacked a detailed analysis of the precise stage at which sensitivity begins.…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of Minimal F-wave Sensitivity in Carpal Tunnel Syndrome

Ege,

Aslanyavrusu

2024

Cureus

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Background and objectiveSeveral recent studies have explored whether F-waves can be a sensitive and useful tool for diagnosing carpal tunnel syndrome (CTS). In light of this, we aimed to measure the minimal F-wave latencies in patients with mild, moderate, and severe electrophysiologically diagnosed carpal CTS, as well as individuals without CTS, to determine at which point this parameter becomes sensitive to the syndrome. Materials and methodsNerve conduction studies were carried out in a room where a temperature of 22-24 °C was maintained. The F-waves of the median nerve in all patients and individuals in the control group were recorded. The F-wave with the highest velocity (minimal F) was categorized into the normal, mild, moderate, and severe groups for statistical analysis. All measurements were performed by the same electrophysiology-experienced neurologist. ResultsPost-hoc analysis demonstrated that the F latency values of the moderate and severe CTS groups were significantly higher than those of the control group (p<0.001 for all comparisons). Furthermore, the F latency values of the severe CTS group were significantly higher than those of the moderate group (p=0.026). ConclusionsBased on our findings, minimal F-wave latency is a reliable indicator of moderate to severe CTS. This sensitivity significantly increases in severe cases while disappearing in the presence of mild CTS.

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“…CTS can occur at any age, but its peak incidence is between 40 and 50 years. Women are also 10 times more prone to this disease than men [ 5 , 6 ]. Although the etiology of CTS is unknown, there are a number of risk factors, including diabetes mellitus, thyroid disease, wrist fracture, rheumatoid arthritis, amyloidosis, acromegaly, and also age and female gender [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The relationship of serum lipid profiles and obesity with the severity of carpal tunnel syndrome

2021

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Introduction Carpal tunnel syndrome (CTS) is a prominent compressive neuropathy. There are a number of risk factors for creating CTS but the effect of these factors on the severity of CTS is unclear. In this study, we aimed to assess the correlation of serum lipid profile and obesity with the severity of CTS. Methods this cross-sectional study was conducted on 118 patients with idiopathic CTS. Blood samples were obtained for determining the serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) after 12 hours of overnight fasting. The participants were then divided into two groups of normal and abnormal serum lipids. Body mass index ≥ 30 kg/m 2 was considered as obesity. The severity of CTS was determined based on the electrophysiological results and Boston CTS Questionnaire (BCTSQ) that evaluates symptoms severity (SSS) and functional status (FSS) of patients. Results out of 118 participants, 108 patients performed lipid profile test that 41.17%, 50.42%, 25.21%, and 20.16% of them had TC ≥ 200, TG ≥ 150, LDL-C ≥ 130, and HDL-C < 60 milligrams per deciliter (mg/dl), respectively. The mean scores of SSS in patients with dyslipidemia including the high level of TC, TG, LDL-C, and low level of LDL-C were 34.59±7.86, 34.05±8.73, 34.93±8.21, and 33.48±7.56, respectively. There was no significant association between lipid profile and the symptom severity scale of CTS (p-value > 0.05). The mean BMI of participants was 31.35±5.35 kg/m 2 , and 58.5% of them had a BMI ≥ 30 kg/m 2 . The mean score of SSS and FSS was 33.18±8.24 and 24.43±7.12 in obese patients (BMI ≥ 30 kg/m 2 ), and was 34.06±7.85 and 23.06±7.67 in patients with BMI < 30 kg/m 2 . We found no significant association between obesity with the SSS and FSS (p-value = 0.53 and 0.32, respectively). In terms of the relationship between electrophysiological grading with obesity, 44 (63.8%) of patients with BMI ≥ 30 kg/m 2 and 22 (45.8%) patients with BMI < 30 kg/m 2 had severe to extreme severe CTS. There was no significant association between obesity and the severity of CTS (p-value = 0.054). Conclusion the results of this study did not demonstrate an association between serum lipid profile and obesity with the severity of carpal tunnel syndrome. The findings of this study may not be extrapolated to other populations. Further studies with more samples are needed to investigate this association.

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Neurophysiologic Pattern and Severity Grading Scale of Carpal Tunnel Syndrome in Sudanese Patients

Cited by 3 publications

References 17 publications

Electro-Physiological Pattern And Severity Grading of Carpal Tunnel Syndrome

Electro-Physiological Pattern And Severity Grading of Carpal Tunnel Syndrome

An Evaluation of Minimal F-wave Sensitivity in Carpal Tunnel Syndrome

The relationship of serum lipid profiles and obesity with the severity of carpal tunnel syndrome

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