The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome

Srikanteswara, Praveen Kumar; Cheluvaiah, Janardhan D; Agadi, Jagadish B.; Nagaraj, Karthik

doi:10.7860/jcdr/2016/20607.8097

Cited by 20 publications

(21 citation statements)

References 9 publications

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“…For example, older patients may have asymptomatic slowing of median nerve on EDX based simply on age. 15 The current study has also demonstrated that US is more accurate in predicting severe CTS in younger patients. In addition, a positive CTS-6 (score >12) also resulted in increased accuracy for US.…”

Section: Resultssupporting

confidence: 63%

Ultrasonography Findings in Severe Carpal Tunnel Syndrome

Nkrumah

Blackburn

Goitz

et al. 2018

Hand (New York, N,Y.)

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Section: Resultssupporting

confidence: 63%

Ultrasonography Findings in Severe Carpal Tunnel Syndrome

Nkrumah

Blackburn

Goitz

et al. 2018

Hand (New York, N,Y.)

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“…In a study, electrophysiological evaluation was shown to be a sensitive method that reflects the pathology independent of the intensity of clinical features (20). Padua et al (21) showed a significant correlation between the electrophysiologic staging and the severity of clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

The relationship between median nerve axon count and clinical findings and electrophysiological parameters in patients with carpal tunnel syndrome

Berk¹,

Nacitarhan²

2019

Ann Med Res

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To determine the association of clinical and electrophysiological findings in cases of carpal tunnel syndrome (CTS) using motor unit (axon) number estimation (MUNE) of the median nerve and to evaluate how these findings can contribute to treatment planning. Material and Methods: Evaluation was made of 43 hands of 25 patients (22 females, 3 males, mean age 45.63±9.89 years) with clinical and electrophysiological diagnosis proven CTS and a healthy control group of 50 hands of 25 subjects (21 females, 4 males, mean age 44.72±8.89 years). Electrophysiological nerve transmission measurements and CTS grading were applied. MUNE measurement was made from the abductor pollicis brevis (APB) muscle with the incremental method. Results: According to the electrophysiological grading, the mean MUNE values were at Grade-0: 134.66±41.00, Grade-1: 78.83±33.51, Grade-2: 71.72±32.15 and Grade-3: 50.25±27.45. A positive correlation was determined between electrophysiological grading and APB muscle atrophy, and median nerve latency. A negative correlation was determined with MUNE, muscle strength, median nerve amplitude and conduction velocity. Between MUNE and muscle strength, median nerve amplitude and conduction velocity there was a positive correlation, between MUNE and median nerve latency, a negative correlation was found. According to regresion analysis, median nerve wrist segment sensory velocity and median nerve distal motor action potential amplitude were predictive parameters for MUNE. Conclusion: Together with the clinical evaluation, patients with grade 3 and/or MUNE value below 2 standard deviations of normal according to the electrophysiological evaluation, should be considered for surgery, while in milder cases, it can be recommended that clinical and electrophysiological follow-up is added to conservative treatment.

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“…La principal fortaleza del estudio es tener un gran número de pacientes, la ausencia de pérdida de datos y la objetividad de las variables medidas para poder realizar la clasificación electrofisiológica. Como se mencionó previamente, varios estudios han demostrado una correlación entre el compromiso clínico y el deterioro de los hallazgos electrofisiológicos, por lo cual los resultados de este estudio aportan evidencia objetiva en la evaluación del compromiso del STC 26 .…”

Section: Discussionunclassified

“…Estos cambios pudiesen ser atribuidos al envejecimiento normal, donde se ha demostrado un aumento en las latencias distales y una disminución en las velocidades de conducción tanto sensitivas como motoras, además de un aumento en la variabilidad de los resultados 27,28 . De todas formas, estudios internacionales han demostrado que en pacientes de mayor edad con STC, el aumento en la latencia distal y la disminución en la velocidad de conducción del nervio mediano son significativamente mayores que en sujetos normales sin STC de la misma edad [29][30][31] . Al ser un estudio retrospectivo, no permite el seguimiento de los pacientes para medir la evolución electrofisiológica del STC con el paso de los años, para lo cual sería adecuado realizar un estudio de cohorte.…”

Section: Discussionunclassified

Descripción electrofisiològica del síndrome de túnel carpiano según edad en pacientes adultos

et al. 2017

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Background: Carpal tunnel syndrome (CTS) represents 90% of entrapment neuropathies. Severity may be greater in older patients. Aim: To describe the electrophysiological findings in adult patients with CTS and determine if severity is related to age. Material and Methods: Descriptive and retrospective study of electrophysiological findings in patients over 18 years of age with clinical suspicion of CTS, studied between January 2011 and December 2015. Neurophysiological severity was classified in 3 grades, comparing them by age, gender and laterality. Results: Of 1156 patients subjected to electrophysiological studies due to a clinical suspicion of CTS, 690 (60%) had electrophysiological features of the disease. In 274 patients (24%) the compromise was mild, in 162 (14%) it was moderate and in 254 (22%) it was severe. There was a positive association between age and CTS severity (p < 0.01). Severity was significantly greater in males than females (p < 0.01). Bilateral CTS was present in 471 patients (68%), which was associated with increased age and severity (p < 0.01). Conclusions: Electrophysiological severity in CTS increases with age. Other factors associated with higher severity are male gender and bilateral disease. (Rev Med Chile 2017; 145: 1252-1258

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The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome

Cited by 20 publications

References 9 publications

Ultrasonography Findings in Severe Carpal Tunnel Syndrome

Ultrasonography Findings in Severe Carpal Tunnel Syndrome

The relationship between median nerve axon count and clinical findings and electrophysiological parameters in patients with carpal tunnel syndrome

Descripción electrofisiològica del síndrome de túnel carpiano según edad en pacientes adultos

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