Abstract
It is known that the major slowing of nerve conduction in the carpal tunnel syndrome occurs in the palm to wrist segment. A technique exploiting this fact and easily applicable in the routine laboratory would be useful in diagnosing early examples of the condition. To this end, orthodromic sensory potentials from stimulation of digits II and V, and of the palmar branches of the median and ulnar nerves were recorded at the wrist in 53 healthy hands, 72 hands with a tentative diagnosis of carpal tunnel syndrome and in 20 hands of patients with unrelated neurological conditions. Using conventional criteria, 53% of the 72 hands from those suspected of carpal tunnel syndrome were thought to have median nerve compression. When conduction velocity in median palm wrist fibres was taken into account, 67% of hands were then considered abnormal. It is concluded that orthodromic sensory action potentials from palmar stimulation provide a rapid, sensitive and acceptable method of diagnosing the carpal tunnel syndrome.
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- Buchthal F., Rosenfalck A. Sensory conduction from digit to palm and from palm to wrist in the carpal tunnel syndrome. J Neurol Neurosurg Psychiatry. 1971 Jun;34(3):243–252. doi: 10.1136/jnnp.34.3.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buchthal F., Rosenfalck A., Trojaborg W. Electrophysiological findings in entrapment of the median nerve at wrist and elbow. J Neurol Neurosurg Psychiatry. 1974 Mar;37(3):340–360. doi: 10.1136/jnnp.37.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cseuz K. A., Thomas J. E., Lambert E. H., Love J. G., Lipscomb P. R. Long-term results of operation for carpal tunnel syndrome. Mayo Clin Proc. 1966 Apr;41(4):232–241. [PubMed] [Google Scholar]
- DAWSON G. D., SCOTT J. W. The recording of nerve action potentials through skin in man. J Neurol Neurosurg Psychiatry. 1949 Nov;12(4):259–267. doi: 10.1136/jnnp.12.4.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eklund G. A new electrodiagnostic procedure for measuring sensory nerve conduction across the carpal tunnel. Ups J Med Sci. 1975;80(1):63–64. doi: 10.3109/03009737509178994. [DOI] [PubMed] [Google Scholar]
- GILLIATT R. W., SEARS T. A. Sensory nerve action potentials in patients with peripheral nerve lesions. J Neurol Neurosurg Psychiatry. 1958 May;21(2):109–118. doi: 10.1136/jnnp.21.2.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GOODWILL C. J. THE CARPAL TUNNEL SYNDROME. LONG-TERM FOLLOW-UP SHOWING RELATION OF LATENCY MEASUREMENTS TO RESPONSE TO TREATMENT. Ann Phys Med. 1965 Feb;8:12–21. [PubMed] [Google Scholar]
- Gilliatt R. W. Sensory conduction studies in the early recognition of nerve disorders. Muscle Nerve. 1978 Sep-Oct;1(5):352–359. doi: 10.1002/mus.880010503. [DOI] [PubMed] [Google Scholar]
- Kimura J. A method for determining median nerve conduction velocity across the carpal tunnel. J Neurol Sci. 1978 Aug;38(1):1–10. doi: 10.1016/0022-510x(78)90240-x. [DOI] [PubMed] [Google Scholar]
- Kimura J. The carpal tunnel syndrome: localization of conduction abnormalities within the distal segment of the median nerve. Brain. 1979 Sep;102(3):619–635. doi: 10.1093/brain/102.3.619. [DOI] [PubMed] [Google Scholar]
- Loong S. C., Seah C. S. Comparison of median and ulnar sensory nerve action potentials in the diagnosis of the carpal tunnel syndrome. J Neurol Neurosurg Psychiatry. 1971 Dec;34(6):750–754. doi: 10.1136/jnnp.34.6.750. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mavor H., Shiozawa R. Antidromic digital and palmar nerve action potentials. Electroencephalogr Clin Neurophysiol. 1971 Mar;30(3):210–221. doi: 10.1016/0013-4694(71)90056-3. [DOI] [PubMed] [Google Scholar]
- Phalen G. S. Reflections on 21 years' experience with the carpal-tunnel syndrome. JAMA. 1970 May 25;212(8):1365–1367. [PubMed] [Google Scholar]
- Phalen G. S. The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am. 1966 Mar;48(2):211–228. [PubMed] [Google Scholar]
- Shivde A. J., Dreizin I., Fisher M. A. The carpal tunnel syndrome. A clinical - electrodiagnostic analysis. Electromyogr Clin Neurophysiol. 1981 Feb-Mar;21(2-3):143–153. [PubMed] [Google Scholar]
- THOMAS P. K. Motor nerve conduction in the carpal tunnel syndrome. Neurology. 1960 Dec;10:1045–1050. doi: 10.1212/wnl.10.12.1045. [DOI] [PubMed] [Google Scholar]
- Thomas J. E., Lambert E. H., Cseuz K. A. Electrodiagnostic aspects of the carpal tunnel syndrome. Arch Neurol. 1967 Jun;16(6):635–641. doi: 10.1001/archneur.1967.00470240073010. [DOI] [PubMed] [Google Scholar]