Second lumbrical and interossei latency difference in Carpal Tunnel Syndrome

Meena, A K; Rao, B. Srinivasa; Sailaja, S.; Mallikarjuna, M; Borgohain, Rupam

doi:10.1016/j.clinph.2008.09.019

Cited by 20 publications

(30 citation statements)

References 17 publications

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“…1,2,5–7) Moreover, it provides useful information for an objective and quantitative assessment of the neurophysiological severity and a decision of therapeutic strategy in patients with CTS. 5–7) The electrophysiological standard examination is conventionally performed by recording the distal motor latency (DML) of the abductor pollicis brevis (APB) muscle and the distal sensory latency (DSL) of the index finger, for evaluation and classification of the severity of the CTS. 5–7) These studies must have high sensitivity and specificity for diagnosis of CTS.…”

Section: Introductionmentioning

confidence: 99%

“…5–7) The electrophysiological standard examination is conventionally performed by recording the distal motor latency (DML) of the abductor pollicis brevis (APB) muscle and the distal sensory latency (DSL) of the index finger, for evaluation and classification of the severity of the CTS. 5–7) These studies must have high sensitivity and specificity for diagnosis of CTS. 1,8) Actually, the DSL is often unrecordable in the severe CTS with the atrophy of the APB.…”

Section: Introductionmentioning

confidence: 99%

“…1,8) Actually, the DSL is often unrecordable in the severe CTS with the atrophy of the APB. 2,5,7) Conversely, it is difficult to detect the early mild CTS with the DML study. 5,7) Only the evaluation by two standard elecrophysiological studies would be not enough to determine the indication and efficacy of wrist splinting for the specific CTS.…”

Section: Introductionmentioning

confidence: 99%

“…2,5,7) Conversely, it is difficult to detect the early mild CTS with the DML study. 5,7) Only the evaluation by two standard elecrophysiological studies would be not enough to determine the indication and efficacy of wrist splinting for the specific CTS. Recently, several studies have reported the high diagnostic sensitivity of second lumbrical-interossei latency difference (2L-INT LD) in CTS, leading the American Association of Electrodiagnostic Medicine to recommend the 2L-INT LD study for the diagnosis of CTS.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…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.…”

Section: Discussionmentioning

confidence: 98%

Lower Tibial Than Peroneal Compound Muscle Action Potential Amplitude in Neuromuscular Diseases

Rubin

Whaley²

2010

Journal of Clinical Neurophysiology

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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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Wrist – Hand

Gentili¹,

Napoli²

2014

The Median Nerve

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Second lumbrical and interossei latency difference in Carpal Tunnel Syndrome

Cited by 20 publications

References 17 publications

Electrophysiological Assessment for Splinting in the Treatment of Carpal Tunnel Syndrome

Electrophysiological Assessment for Splinting in the Treatment of Carpal Tunnel Syndrome

Lower Tibial Than Peroneal Compound Muscle Action Potential Amplitude in Neuromuscular Diseases

Wrist – Hand

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