Volume 4, Issue 3 (2019)
IJMPP 2019, 4(3): 227-233 |
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Darweesh H, Raya S A, kamel M M, Makram M. Median Versus Ulnar Sensory and Motor Latency Difference in Early Diagnosis of Carpal Tunnel Syndrome. IJMPP 2019; 4 (3) :227-233
URL: http://ijmpp.modares.ac.ir/article-32-38580-en.html
URL: http://ijmpp.modares.ac.ir/article-32-38580-en.html
1- Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt
2- National Institute of Neuro-Motor System, Giza, Egypt , Sohaaburaya2014@yahoo.com
3- National Institute of Neuro-Motor System, Giza, Egypt
2- National Institute of Neuro-Motor System, Giza, Egypt , Sohaaburaya2014@yahoo.com
3- National Institute of Neuro-Motor System, Giza, Egypt
Abstract: (2068 Views)
Aim: This study proposed to detect sensitivity of different electrophysiological techniques in early diagnosis of Carpal Tunnel Syndrome (CTS) compared to the standard technique as Median Sensory Latency.
Methods and Instrument: The present study included 70 hands (40 hands with clinical evidence of idiopathic CTS and 30 hands as control group). The following tests were done for both groups: 1- Sensory nerve conduction study: median nerve, ulnar nerve, median versus ulnar latency difference between second and fifth digits, median versus ulnar latency difference (ring finger) 2- Motor nerve conduction study: median nerve, ulnar nerve, median versus ulnar motor latency difference.
Findings: The most sensitive (92%) two tests were median-ulnar sensory latency difference recorded from second and fifth digits and median-ulnar sensory latency difference recorded from fourth digit, while median-ulnar motor latency difference and median motor latency showed lowest sensitivity (61, 53%) respectively.
Conclusion: Median-ulnar sensory latency difference recorded from digit two and digit five and that recorded from digit 4 have highest sensitivity for early detection of CTS.
Keywords: Carpal Tunnel Syndrome; Median Versus Ulnar Latency Differences; Nerve Conduction Study.
Methods and Instrument: The present study included 70 hands (40 hands with clinical evidence of idiopathic CTS and 30 hands as control group). The following tests were done for both groups: 1- Sensory nerve conduction study: median nerve, ulnar nerve, median versus ulnar latency difference between second and fifth digits, median versus ulnar latency difference (ring finger) 2- Motor nerve conduction study: median nerve, ulnar nerve, median versus ulnar motor latency difference.
Findings: The most sensitive (92%) two tests were median-ulnar sensory latency difference recorded from second and fifth digits and median-ulnar sensory latency difference recorded from fourth digit, while median-ulnar motor latency difference and median motor latency showed lowest sensitivity (61, 53%) respectively.
Conclusion: Median-ulnar sensory latency difference recorded from digit two and digit five and that recorded from digit 4 have highest sensitivity for early detection of CTS.
Keywords: Carpal Tunnel Syndrome; Median Versus Ulnar Latency Differences; Nerve Conduction Study.
Article Type: Original Research |
Subject:
Musculoskeletal Pain Prevention
Received: 2019/11/30 | Accepted: 2020/01/11 | Published: 2020/01/21
Received: 2019/11/30 | Accepted: 2020/01/11 | Published: 2020/01/21
References
1. Wipperman J and Goerl K. carpal tunnel syndrome: diagnosis and management. Am Fam Physician. (2016); 94 (12): 993- 999.
2. Joshi AG and Gargate AR. Diagnostic Utility of F Waves in Clinically Diagnosed Patients of Carpal Tunnel Syndrome. Indian J Physiol Pharmacol. (2013); 57(4): 372-377.
3. Hegab SE, Senna MK, Hafez EA, Farag SE. Toward sensitive and specific electrodiagnostic techniques in early carpal tunnel syndrome. Egyptian Rheumatology & Rehabilitation. (2018) ; 45(2):57-64. [DOI:10.4103/err.err_41_17]
4. Preston DC and Shapiro BE. Electromyography and neuromuscular disorder. (2013); (3rd ed). Elsevier Saunders, Newyork : 90-114 [DOI:10.1016/B978-1-4557-2672-1.00009-X]
5. SanderHW, Quinto C, Saadeh PB and Chokroverty S. Sensitive median-ulnar motor comparative techniques in carpal tunnel syndrome. Muscle Nerve. (1999) 22 (1): 88-98.
https://doi.org/10.1002/(SICI)1097-4598(199901)22:1<88::AID-MUS13>3.0.CO;2-C [DOI:10.1002/(SICI)1097-4598(199901)22:13.0.CO;2-C]
6. Werner RA and Andary M. Electro diagnostic evaluation of carpal tunnel syndrome. Muscle Nerve. (2011); 44: 597-607. [DOI:10.1002/mus.22208]
7. Kiernan MC, Mogyoros I, Burke D. Conduction block in carpal tunnel syndrome. Brain. (1999); 122: 933-941. [DOI:10.1093/brain/122.5.933]
8. Saba EK and El-Tawab SS. Ulnar Nerve Changes Associated with Carpal Tunnel Syndrome not Affecting Median Versus Ulnar Comparative Studies. World Journal of medical sciences. (2014); 11 (4): 600-608.
9. Jablecki CK, Andary MT, So YT, Wilkins DE and Williams FH.Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve. (1993); 16:1392-1414. [DOI:10.1002/mus.880161220]
10. Uncini A, Di Muzio A, Awad J, Manante G, Tafuro M, Gambi D. Sensitivity of three median to ulnar comparative tests in diagnosis of mild carpal tunnel syndrome. Muscle Nerve. (1993) ; 16:1366-73. [DOI:10.1002/mus.880161215]
11. Cioni R, Passero S, Paradiso C, Giannini F, Battistini N, Rushworth G. Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. J Neurol. (1989); 236: 208-13. [DOI:10.1007/BF00314501]
12. Kodama M, Tochikura M, Sasao Y, Kasahara T, Koyama Y, Aono K, et al. What is the most sensitive test for diagnosing carpal tunnel syndrome?. Tokai J Exp Clin Med. (2014) ; 39(4):172-7.
13. Aygül R, Ulvi H, Kotan D, Kuyucu M Demir R. Sensitivities of conventional and new electrophysiological techniques in carpal tunnel syndrome and their relationship to body mass index. J Brachial Plex Peripher Nerve Inj. (2009) ; 31: 4-12.
14. Stevens JC. AAEM minimonograph #26: the electrodiagnosis of carpal tunnel syndrome. Muscle Nerve. (1997); 20:1477-86.
https://doi.org/10.1002/(SICI)1097-4598(199712)20:12<1477::AID-MUS1>3.0.CO;2-5 [DOI:10.1002/(SICI)1097-4598(199712)20:123.0.CO;2-5]
15. Demirci S and Sonel B. Comparison of sensory conduction techniques in the diagnosis of mild idiopathic carpal tunnel syndrome: which finger, which test ?. Rheumatol Int. (2004); 24: 217-220. [DOI:10.1007/s00296-003-0351-y]
16. Chang MH, Wei SJ, Chiang HL, Wang HM, Hsieh PF, Huang SY. Comparison of motor conduction techniques in the diagnosis of carpal tunnel syndrome. Neurology. (2002); 11: 1603-07. [DOI:10.1212/WNL.58.11.1603]
17. Saba EK. Median versus ulnar medial thenar motor recording in diagnosis of carpal tunnel syndrome. Egyptian Society of Rheumatic Diseases. The Egyptian Rheumatologist. (2015); 37:139-146. [DOI:10.1016/j.ejr.2014.11.001]
18. Tawfik EA, El Zohiery AK, Abaza NM. The second lumbrical-interossei latency difference in carpal tunnel syndrome: Is it a mandatory or a dispensable test?. Alexandria Journal of Medicine. (2013); 49: 199-205. [DOI:10.1016/j.ajme.2012.11.001]
19. Loscher WN, Auer-Grumbach M, Trinka E, Ladurner G, Hartung HP. Comparison of second lumbrical and interosseous latencies with standard measures of median nerve function across the carpal tunnel: a prospective study of 450 hands. J Neurol. (2000); 247: 530-4. [DOI:10.1007/s004150070152]
20. Sheean GL, Houser MK, Murray NM. Lumbricalinterosseous latency comparison in the diagnosis of carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol. (1995); 97:285-9. [DOI:10.1016/0924-980X(95)00197-S]
21. Prseton DC and Logigian EL. Lumbrical and interossei recording in carpal tunnel syndrome. Muscle Nerve. (1992) ; 15: 1253-7. [DOI:10.1002/mus.880151106]
22. Aydin G, Keles I, Ozbudak Demir S, Baysal AY. Sensitivity of median sensory conduction tests in digital branches for diagnosis of carpal tunnel syndrome. Phys Med Rehabil. (2004) ; 83(1): 17- 21. [DOI:10.1097/01.PHM.0000104662.71129.B9]
23. Thomus JM, Xuan Kong, Shai N Gozani. Utility of nerve conduction studies for carpal tunnel syndrome by family medicine, primary care and internal medicine physicians. The journal of the American board of family medicine. (2007) ; 20: 60-64. [DOI:10.3122/jabfm.2007.01.060111]
24. Lin CS, Kuwabara S, Cappelen Smih C, Burke D. Responses of human sensory and motor axons to the release of ischaemia and to hyperpolarizing currents. J Physiol. (2002) ; 541: 1025-1039. [DOI:10.1113/jphysiol.2002.017848]
25. Ginanneschi F, Dominici F, Milani P, Biasella A, Rossi A. Evidence of altered motor axon properties of the ulnar nerve in carpal tunnel syndrome. Clin Neurophysiol. (2007); 118 : 1569- 1576. [DOI:10.1016/j.clinph.2007.03.024]
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