Carpal tunnel syndrome: which electrodiagnostic path should we follow? A prospective study of 100 consecutive patients.
We prospectively studied 100 consecutive patients (200 hands) sent to our Neurophysiopathology Service for a suspected Carpal Tunnel Syndrome (C.T.S.). We performed 6 different motor and sensitive electrodiagnostic tests on both hands of each patients and on 25 healthy subjects. We calculated the sensibility and the specificity of each test by comparing each parameter with all the other ones, and then, again, using the clinical evaluation as a "gold standard". The routinely performed tests proved to have a high sensibility in detecting C.T.S., nevertheless, sometimes they do not give a definite response. In these cases we suggest to carry out the neurophysiological examination by performing some of the newly proposed tests. We end our study by drawing a "flow-chart", which considers reliability, sensibility, difficulty in performing and/or evaluating, and discomfort for patients, of each test; by this we would give a guide and a practical aid in determining the electrophysiological path for C.T.S. diagnosis.
Foresti
C
C
Neurophysiopathology Service, Ospedali Riuniti di Bergamo, Italy.
Quadri
S
S
Rasella
M
M
Tironi
F
F
Viscardi
M
M
Ubiali
E
E
D000200:Action Potentials / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D003663:Decision Trees; D004568:Electrodiagnosis / Q000706:statistics & numerical data; D004594:Electrophysiology; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D005385:Fingers / Q000294:innervation; D006225:Hand / Q000294:innervation; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009475:Neurons, Afferent / Q000502:physiology; D009482:Neurophysiology; D011446:Prospective Studies; D011930:Reaction Time; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013933:Thumb / Q000294:innervation; D014459:Ulnar Nerve / Q000503:physiopathology; D014953:Wrist / Q000294:innervation