Comparative analysis of various electrophysiological methods for the diagnosis of carpal tunnel syndrome

Dr. Deepak Jain; Dr. Pankaj Kumar Saini

Volume : VIII, Issue : VII, July - 2019

Comparative analysis of various electrophysiological methods for the diagnosis of carpal tunnel syndrome

Dr. Deepak Jain, Dr. Pankaj Kumar Saini

Abstract :

Background: Patients with Mild Carpal tunnel syndrome (CTS) may not be picked up by routine nerve conduction methods. So, this study was performed to identify the most sensitive way to detect mild to moderate Carpal tunnel syndrome and to evaluate the sensitivity of different methods for diagnosis of carpal tunnel syndrome.

Material and method: We included sixty clinically confirmed CTS patients in our study. We recorded the clinical characteristics and laboratory features in a proforma. We also included sixty healthy age and sex–matched asymptomatic individuals as controls in our study. We excluded patients with underlying peripheral neuropathy. We included Median distal motor latency, Median distal sensory latency, Median–versus–ulnar 2^nd Lumical–interossei comparison study, Median–versus–ulnar wrist–to–digit four comparison study, Median –versus– Radial thumb sensory study, Median–versus–ulnar motor distal latency difference, and Median–versus–ulnar sensory latency difference tests in our study.

Results: Out of sixty patients, female: male ratio was 2.3:1, and the mean age was 44.28�11.41 years. The mean symptom duration was 0.76�0.03 years. Out of 42 females, 38(90.4%) were engaged in daily household activities. In patients group median nerve distal motor latency was 5.024�2.05 ms, whereas sensory latency was 3.53�0.75 ms. We found maximum sensitivity in Median–versus–ulnar wrist–to–digit four comparison study (90.19%). In Median–versus–Radial thumb sensory study sensitivity was 88.23%, followed by Median–versus–ulnar 2^nd Lumical– interossei comparison study (86.27%). We found lowest sensitivity (72.55%) in Median distal motor latency test.

Conclusion: Electrophysiological tests including Median–versus–ulnar wrist–to–fourth digit comparison study, and comparative study of Median–versus–ulnar 2^nd Lumical– interossei should be included to diagnose mild CTS patients with normal Median distal motor latency, and median distal sensory latency tests.