Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: Summary statement

Jablecki, Charles K.; Andary, Michael; Floeter, Mary Kay; Miller, Robert G.; Quartly, Caroline; Vennix, Michael J.; Wilson, John R.; Franklin, Gary M.; Zahn, Catherine; Alter, Milton; Ashwal, Stephen; Dotson, Rose M.; Dubinsky, Richard; French, Jacqueline; Friday, Gary; Glantz, Michael; Gronseth, Gary S.; Hirtz, Deborah; Stevens, J. Clarke; Thurman, David J.; Weiner, William J.; Cianca, John; Francisco, Gerard E.; Hedge, Thomas L.; Janora, Deanna M.; Kumar, Ajay; Malanga, Gerard A.; Meythaler, Jay M.; Salvi, Frank J.; Zorowitz, Richard D.; Ball, Richard D.; Cherington, Michael; Fisher, Morris A.; Phillips, Lawrence H.; So, Yuen T.; Tulloch, John W.; Turk, Margaret A.; Wiechers, David O.; Wilbourn, Asa J.; Wilkins, Dennis E.; Williams, Faren H.; Ysla, Roy G.; Rosenberg, Jay H.; Daube, Jasper R.; Frishberg, Benjamin; Greenberg, Michael K.; Lanska, Douglas J.; Paulson, George W.; Pearl, Richard A.; Sila, Cathy A.; Granger, Carl V.; DeLisa, Joel A.; LaBan, Myron M.; Lieberman, James S.; Tomski, Mark A.

doi:10.1002/mus.10185

Cited by 338 publications

(70 citation statements)

References 5 publications

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“…Thirty patients who met electrodiagnostic (AANEM, 2002) and clinical (AAN, 1993) criteria for carpal tunnel syndrome were recruited through the local print media, advertisements on public notice boards and the neurophysiology clinic at the local hospital. Patients were excluded if electrodiagnostic findings were indicative of peripheral neuropathies other than carpal tunnel syndrome, if another medical condition that affected the upper extremity or neck was present, if a history of previous surgery or significant trauma to the upper limb or neck existed, or if carpal tunnel syndrome was related to pregnancy or diabetes.…”

Section: Methodsmentioning

confidence: 99%

The relationship of nerve fibre pathology to sensory function in entrapment neuropathy

Schmid

Bland

Bhat

et al. 2014

Brain

118

141

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Section: Methodsmentioning

confidence: 99%

The relationship of nerve fibre pathology to sensory function in entrapment neuropathy

Schmid

Bland

Bhat

et al. 2014

Brain

118

141

View full text Add to dashboard Cite

show abstract

“…All electrophysiological examinations were performed according to the American Association of Electrodiagnostic Medicine (AAEM) guidelines 15) by one examiner (M.N.) using a Neuropack X1 MEB 2312 (Nihon Kohden Corporation, Tokyo, Japan) before the wrist splinting therapy in all patients and immediately after splinting therapy in 42 patients.…”

Section: Methodsmentioning

confidence: 99%

Electrophysiological Assessment for Splinting in the Treatment of Carpal Tunnel Syndrome

Nanno

Kodera

Tomori

et al. 2017

Neurol. Med. Chir.(Tokyo)

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An electrophysiological study is commonly used to decide a therapeutic strategy for carpal tunnel syndrome (CTS). In this study, the electrophysiological parameter measurement as a prognostic indicator for CTS after wrist splinting was assessed to identify appropriate candidates for wrist splinting for CTS. One hundred and six hands in 78 patients with CTS were treated by wrist splinting, and three electrophysiological parameters; median distal motor latency (DML) of the abductor pollicis brevis (APB) muscle, median distal sensory latency (DSL) of the index finger, and second lumbrical-interossei latency difference (2L-INT LD); were statistically analyzed to compare with clinical results by Kelly’s evaluation respectively. Clinical results were excellent in 15 hands, good in 51 hands, fair in 19 hands, and poor in 21 hands. The recordable rate in 2L-INT LD (99.1%) was higher than DML (96.2%) and DSL (79.2%). Patients with DML less than 6.5 ms, DSL less than 5.7 ms, or 2L-INT LD less than 2.5 ms had significantly excellent or good clinical results. The odds ratios of the DML, DSL, and the 2L-INT LD were 7.93, 8.81, and 12.8, respectively. This study demonstrated that CTS patients with DML less than 6.5 ms, DSL less than 5.7 ms, or 2L-INT less than 2.5 ms were good candidates for wrist splinting. Especially, the 2L-INT LD could be the most reliable indicator to predict clinical results for all grades of CTS. This electrophysiological information could be useful in further improvement of accurate diagnosis of CTS, and may help in the assessment of appropriate treatment for CTS with wrist splinting.

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“…As proposed by Johnson et al [19], the active electrode was attached on the sensory area of median nerve and ulnar nerve on the proximal interphalangeal joint of the 4th finger, and 14 cm proximal; the median nerve and ulnar nerve were stimulated to compare the onset latency. The diagnostic standard for CTS was based on the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) recommendations [20]. …”

Section: Methodsmentioning

confidence: 99%

Relationship Between Electrodiagnosis and Various Ultrasonographic Findings for Diagnosis of Carpal Tunnel Syndrome

Lee

Kim

2016

Ann Rehabil Med

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ObjectiveTo investigate the relationship between electrodiagnosis and various ultrasonographic findings of carpal tunnel syndrome (CTS) and propose the ultrasonographic standard that has closest consistency with the electrodiagnosis.MethodsUltrasonography was performed on 50 female patients (65 cases) previously diagnosed with CTS and 20 normal female volunteers (40 cases). Ultrasonography parameters were as follows: cross-sectional area (CSA) and flattening ratio (FR) of the median nerve at the levels of hamate bone, pisiform bone, and lunate bone; anteroposterior diameter (AP diameter) of the median nerve in the carpal tunnel; wrist to forearm ratio (WFR) of median nerve area at the distal wrist crease and 12 cm proximal to distal wrist crease; and compression ratio (CR) of the median nerve. Independent t-test was performed to compare the ultrasonographic findings between patient and control groups. Significant ultrasonographic findings were compared with the electrodiagnosis results and a kappa coefficient was used to determine the correlation.ResultsCSA and FR of median nerve at the hamate bone level, CSA of median nerve at pisiform bone level, AP diameter of median nerve within the carpal tunnel, CSA of median nerve at the distal wrist crease and WFR showed significant differences between patient and control groups. WFR showed highest concordance with electrodiagnosis (κ=0.71, p<0.001).ConclusionThese findings suggested the applicability of ultrasonography, especially WFR, as a useful adjunctive tool for diagnosis of CTS.

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Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: Summary statement

Abstract: The reader is referred to the updated review 2 for a detailed discussion of the literature and the EDX techniques for the assessment of CTS which are summarized here. Both reviews addressed the following key clinical questions:

Cited by 338 publications

References 5 publications

The relationship of nerve fibre pathology to sensory function in entrapment neuropathy

The relationship of nerve fibre pathology to sensory function in entrapment neuropathy

Electrophysiological Assessment for Splinting in the Treatment of Carpal Tunnel Syndrome

Relationship Between Electrodiagnosis and Various Ultrasonographic Findings for Diagnosis of Carpal Tunnel Syndrome

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