Utility of nerve conduction study in early diagnosis of carpal tunnel syndrome (CTS)

Abstract

Background: Carpal tunnel syndrome (CTS) is the commonest median nerve entrapment neuropathy with preponderance in females. Aims & Objective: The present study was carried out for early conformation of clinically diagnosed patients of Carpal Tunnel Syndrome (CTS) by electrodiagnostic tests which include motor conduction, sensory conduction, and F-wave studies. Materials and Methods: Early confirmation of clinically suspected patients of CTS by performing electrodiagnostic tests of median and ulnar nerves. 100 subjects of age group 30-50 years (50 clinically suspected patients of CTS, 50 as control group) were studied. Motor and Sensory conduction velocities, distal motor and sensory latencies and F wave latencies were performed using Medtronic Keypoint @ 2 EMG EP software. Results: Statistically significant (P<0.001) slowing of motor conduction velocities for median nerve was seen in the CTS group as compared to control group. Statistically significant (P<0.001) increase in distal motor and sensory latencies was observed for both median and ulnar nerves in CTS group with more increase in distal motor latency than sensory latency. Increase in F wave latencies of both nerves was seen in CTS group. Conclusion: Electrophysiological studies confirmed the early diagnosis of CTS with a high degree of sensitivity. Present results confirm selective slowing of sensory and motor conduction within wrist to palm segment in patients of CTS due to compression by the transverse carpel ligament or to disease process of terminal segment.

Study of wrist ratio and wrist-to-palm index radio in individuals suffering from carpal tunnel syndrome

“…The present study also shows statistically significant increase in F wave latencies of median and ulnar nerves. This observation is consistent with the findings of author’s[ 7 15 18 ] similarly; the results of the present study in relation to criteria for diagnosing CTS are similar to those of Mishra et al . and Nathan et al .…”

“…[ 5 ] Statistically significant increase in the difference between distal sensory latency of median and ulnar nerves was observed, which is consistent with the results of author's work and with Mishra et al . [ 6 7 14 ] General observations suggested that a 0.70 WR may be the critical shape of the wrist at which latencies tend to reach the upper limits of normal. [ 8 9 15 16 17 18 19 ] The cause for prolonged latencies of F waves and conduction velocities in ulnar nerve were not common, it may occur due to underlying lesions.…”

“…Systemic conditions such as obesity, diabetes, thyroid dysfunction, amyloidosis, and Raynaud's syndrome are sometimes associated with the syndrome. [ 5 6 7 8 9 ] Aberrant muscles of forearm and thrombosis of the median artery contribute to median nerve compression. [ 10 ] The sensory and motor axons show a comparable incidence of abnormalities, often encountering selective involvement of motor fibers, with normal sensory conduction or vice versa.…”