scholarly journals Assessment of the diagnostic accuracy of nerve conduction study and the correlation between severity of symptoms and nerve conduction studies in carpal tunnel syndrome

2019 ◽  
Vol 5 (4) ◽  
pp. 559
Author(s):  
Benjamin Alex ◽  
Mithun Joy Kattoor ◽  
Samson Samuel Edayalamuriyil
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Diagnostic Accuracy ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Symptom Severity ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Severity Scores ◽  
Tunnel Syndrome ◽  
Surgical Release

<p class="abstract"><strong>Background:</strong> This study was done to assess the diagnostic accuracy of nerve conduction study in carpal tunnel syndrome and comparability of nerve conduction measures before and after carpal tunnel release.</p><p class="abstract"><strong>Methods:</strong> 31 patients (30 females and 1 male) with carpal tunnel syndrome were subjected to nerve conduction study and Boston symptom severity scores before surgery and at 3 months post-operative period and nerve conduction values compared. The effect of duration of symptoms on nerve conduction values was studied.<strong></strong></p><p class="abstract"><strong>Results:</strong> Nerve conduction studies were found to be reliable in diagnosing carpal tunnel syndrome. 61.30% patients showed a right-handed involvement, or right side getting affected first in a bilateral case. 60-80% patients had Boston symptom severity scores which were comparable to the nerve conduction grades ascertaining the relationship between them. Only 58.8% patients with extreme and severe NCS grades preoperatively showed improvement post-surgical release. In patients with symptoms for more than 12 months, only 33.33% had improved nerve conduction grades post-surgical release at 3 months, validating the need for early surgical release.</p><p class="abstract"><strong>Conclusions:</strong> Nerve conduction study was found to be a reliable diagnostic modality for diagnosis of carpal tunnel syndrome and nerve conduction study values correlated with the Boston symptom severity score. The post-operative nerve conduction values revealed definite neurological improvement in patients who underwent early surgical management. Hence, we recommend early release for carpal tunnel syndrome patients for speedy recovery from the condition.</p>

Carpal tunnel decompression in patients with normal nerve conduction studies

2019 ◽  
Vol 45 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Samuel P. Mackenzie ◽  
Oliver D. Stone ◽  
Paul J. Jenkins ◽  
Nicholas D. Clement ◽  
Iain R. Murray ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Clinical Features ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Study Groups ◽  
Nerve Conduction Studies ◽  
Level Of Evidence ◽  
Tunnel Syndrome ◽  
Normal Nerve Conduction

Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management. Preoperative QuickDASH scores were comparable in both groups (58 vs 54.8). However, there were significant differences between the normal and abnormal nerve conduction study groups in the QuickDASH at 1 year (34.9 vs 21.5) and change in QuickDASH postoperatively (23.1 vs 33.4). Patients with normal nerve conduction studies had comparable preoperative disability scores compared with those with abnormal studies. Although they had a significant improvement in QuickDASH at 1 year, this was significantly less than those with abnormal nerve conduction studies. Level of evidence: III

scholarly journals Relationship between nerve conduction studies and the Functional Dexterity Test in workers with carpal tunnel syndrome

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesco Sartorio ◽  
Francesca Dal Negro ◽  
Elisabetta Bravini ◽  
Giorgio Ferriero ◽  
Stefano Corna ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Diagnostic Accuracy ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
High Specificity ◽  
Nerve Conduction Studies ◽  
Likelihood Ratios ◽  
Discriminative Ability ◽  
Convenience Sample ◽  
Tunnel Syndrome

Abstract Background Dexterity impairments caused by carpal tunnel syndrome (CTS) make working and daily activities challenging. We aimed to investigate: i) the relationship between dexterity and nerve conduction studies (NCS) in workers with classic symptoms presentation; ii) the ability of the Functional Dexterity Test (FDT) to discriminate different levels of CTS severity as classified by NCS; iii) the diagnostic accuracy of a clinical battery composed of the FDT, Phalen’s test and Tinel’s sign. Methods In a convenience sample of individuals diagnosed with CTS, we correlated FDT net scores with the NCS-based classification by means of Spearman’s (rho) test. Discriminative ability of the FDT was assessed by ANOVA, and a ROC curve determined cutoff thresholds. Sensitivity, specificity, and likelihood ratios (LRs) were used to investigate the diagnostic accuracy of the clinical battery. Results Data from 180 hands were collected. The FDT was significantly correlated (rho = 0.25, p <  0.001) with NCS. The FDT was able to discriminate subjects with severe/extreme NCS findings, and two thresholds (0.29–0.36) were identified. Adding the FDT to the provocative tests improved the overall diagnostic accuracy (specificity: 0.97, CI95% 0.83–0.99; LR+: 14.49, CI95% 2.09–100.53). Conclusions Sensorimotor impairments related to CTS can affect hand dexterity. The FDT discriminated patients with severe NCS involvement. Positive results on the clinical battery (Phalen, Tinel, and FDT) could help to confirm the CTS diagnosis, showing a very high specificity and LR+. On the contrary, the low sensitivity is not able to rule out CTS in individuals with negative results.

Effects of Diacutuaneous Fibrolysis on Mechanosensitivity, Disability and Nerve Conduction Studies in Mild to Moderate Carpal Tunnel Syndrome: Secondary Analysis of a Randomized Controlled Trial

2020 ◽  
Author(s):  
Sandra Jiménez del Barrio ◽  
Luis Ceballos Laita ◽  
Elena Bueno Gracia ◽  
Sonia Rodríguez Marco ◽  
María Haddad Garay ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Nerve Conduction ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome

Abstract Objective People diagnosed with carpal tunnel syndrome (CTS) have fibrosis between the soft, connective, and neural tissues that could worsen the compression of the median nerve. The diacutaneous fibrolysis (DF) technique may release tissue adhesions and increase the mobility of connective tissues. The purpose of this study was to compare the outcomes of DF in people with mild to moderate CTS on mechanosensitivity, disability, and nerve conduction studies. Methods This was a secondary analysis of a double-blinded, randomized placebo-controlled trial. Patients were recruited between April and September 2016 from the Department of Neurophysiology at the Hospital Miguel Servet, Zaragoza, Spain. Thirty-nine people (52 wrists) diagnosed with mild to moderate CTS were included. Participants were randomly assigned to either the DF group (n = 26) or the Sham group (n = 26). Both groups received 5 therapy sessions, 2 sessions per week. Mechanosensitivity with the Upper Limb Neurodynamic Test 1 (ULNT1), symptom severity and functional status with the Boston Carpal Tunnel Questionnaire (BCTQ), and median nerve sensory conduction velocity with nerve conduction studies were the outcomes measured. Assessments were recorded at baseline and after the intervention. Results The DF group showed significant improvements in the following: mechanosensitivity, with 28.46 degrees of elbow extension ROM (95% CI = 19.2–37.7); for BCTQ symptom severity and functional status score, with an increase of 1.0 point (95% CI = 0.7–1.4); and sensory conduction velocity of median nerve, which improved to 5.8 m/s (95% CI = 2.5–9.2). Conclusion Participants with mild to moderate CTS experienced improvements in symptom severity, functional status, mechanosensitivity, and nerve conduction studies after 5 sessions of DF.

scholarly journals Prevalence of asymptomatic neurophysiological carpal tunnel syndrome in 130 healthy individuals

2016 ◽  
Vol 8 (4) ◽  
Author(s):  
Omar Alrawashdeh
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Healthy Individuals ◽  
Tunnel Syndrome ◽  
Asymptomatic Individuals ◽  
Median Neuropathy

Diagnosis of carpal tunnel syndrome (CTS) is frequently confirmed by performing nerve conduction studies. Previous studies demonstrated that abnormal nerve conduction study (NCS) is suggestive of CTS among asymptomatic individuals. However, previous studies included individuals with risk factors for the syndrome. A NCS was performed on the median and ulnar nerves in 130 healthy individuals. About 15% of individuals in this study demonstrated electrodiagnostic evidence of carpal tunnels syndrome. Four cases have shown signs of isolated median neuropathy with normal median sensory component. Results indicated that the most widely used method for confirming diagnosis of CTS may have up to 15% of false positives. However, most of those showed changes of minimal CTS. Isolated prolongation of the median motor latency should be investigated further as they are usually classified as moderate to severe CTS and may undergo unnecessary surgeries.

scholarly journals Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands

2009 ◽  
Vol 67 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Dante Guilherme Velasco Hardoim ◽  
Guilherme Bueno de Oliveira ◽  
João Aris Kouyoumdjian
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Sensory Nerve ◽  
Nerve Conduction Studies ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Compound Action

OBJECTIVE: To compare a long-term carpal tunnel syndrome (CTS) on nerve conduction studies (NCS) in hands treated non-surgically. METHOD: We retrospectively selected 261 symptomatic CTS hands (166 patients), all of them confirmed by NCS. In all cases, at least 2 NCS were performed in an interval greater than 12 months. Cases with associated polyneuropathy were excluded. NCS parameters for CTS electrodiagnosis included a sensory conduction velocity (SCV) <46.6 m/s (wrist to index finger, 14 cm) and distal motor latency (DML) >4.25 ms (wrist to APB, 8 cm). RESULTS: 92.8% were women; mean age was 49 years (20-76); the mean interval between NCS was 47 months (12-150). In the first exam, the median sensory nerve action potential (SNAP) and the compound action muscular potential were absent in 9.8% and 1.9%, respectively. In the second/last exam, SCV worsened in 54.2%, remained unchanged in 11.6% and improved in 34.2%. SNAP amplitude worsened in 57.7%, remained unchanged in 13.1% and improved in 29.2%. DML worsened in 52.9%, remained unchanged in 7.6% and improved in 39.5%. Overall, NCS parameters worsened in 54.9%, improved in 34.3% and remained unchanged in 10.8%. CONCLUSION: Long-term changing in NCS of CTS hands apparently were not related to clinical symptomatology and could lead to some difficulty in clinical correlation and prognosis. Aging, male gender and absent SNAP were more related to NCS worsening, regardless the mean interval time between the NCS.

scholarly journals Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

2021 ◽  
Vol 8 (11) ◽  
pp. 181
Author(s):  
Konstantinos I. Tsamis ◽  
Prokopis Kontogiannis ◽  
Ioannis Gourgiotis ◽  
Stefanos Ntabos ◽  
Ioannis Sarmas ◽  
...  
Keyword(s):  
Machine Learning ◽  
Decision Making ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Automatic Detection ◽  
Nerve Conduction Studies ◽  
Machine Learning Techniques ◽  
Tunnel Syndrome

Recent literature has revealed a long discussion about the importance and necessity of nerve conduction studies in carpal tunnel syndrome management. The purpose of this study was to investigate the possibility of automatic detection, based on electrodiagnostic features, for the median nerve mononeuropathy and decision making about carpal tunnel syndrome. The study included 38 volunteers, examined prospectively. The purpose was to investigate the possibility of automatically detecting the median nerve mononeuropathy based on common electrodiagnostic criteria, used in everyday clinical practice, as well as new features selected based on physiology and mathematics. Machine learning techniques were used to combine the examined characteristics for a stable and accurate diagnosis. Automatic electrodiagnosis reached an accuracy of 95% compared to the standard neurophysiological diagnosis of the physicians with nerve conduction studies and 89% compared to the clinical diagnosis. The results show that the automatic detection of carpal tunnel syndrome is possible and can be employed in decision making, excluding human error. It is also shown that the novel features investigated can be used for the detection of the syndrome, complementary to the commonly used ones, increasing the accuracy of the method.

scholarly journals KINESIOLOGY TAPING AND NEURAL GLIDING EXERCISE IN CARPAL TUNNEL SYNDROME

2020 ◽  
Vol 7 (7) ◽  
pp. 13-16
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Studies ◽  
Factory Workers ◽  
Wrist Movement ◽  
Tingling Sensation ◽  
Repetitive Injury ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Introduction: Carpal Tunnel Syndrome (CTS) is a condition of neuropathy caused by median nerve entrapment, which is related to repetitive injury mostly due to workload. Some people have occupation that require a lot of repetitive wrist movement such as cigarette factory workers. Kinesiology taping and neural gliding exercises are conservative interventions, which can be performed on people with CTS. Case: This case report showed that there was improvement symptom of carpal tunnel syndrome treated with kinesiology taping and neural gliding exercise. The patient was female, 43 years old, a cigarette factory worker. She had complains of tingling sensation on her palms, moreover on finger 1, 2 and 3 since 2 weeks before. The physical examination revealed positive test of carpal tunnel syndrome such as Phalen, Pressure Provocation and Tinel test. Boston Carpal Tunnel Questionnaire (BCTQ) was also performed. The diagnose was confirmed with nerve conduction studies result. Kinesiology taping was applied on this patient and reapplied weekly until 4 weeks. Patient was also taught about neural gliding exercise and was asked to do it every day for 4 weeks. BCTQ was evaluated weekly and improved every week. While nerve conduction studies was evaluated in 4 weeks and there was also improvement in the result. Conclusion: The improved outcome occurring in this case shows that kinesiology taping and neural gliding exercise can be considered as management of carpal tunnel syndrome, but of course further research is needed to prove its significance.

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