[Electrophysiological study of 921 cases of carpal tunnel syndrome: its application for prognosis and treatment].
A neurophysiological study of 921 hands with clinical manifestations of carpal tunnel syndrome (CTS), 88 of normal individuals and 588 of patients with disorders not related with median neuropathy was carried out to establish the diagnostic sensibility 130 non-operated on patients with slight CTS were controlled one year later. The same was achieved with 105 surgically treated patients in order to establish the electrophysiological changes related to therapeutic methods. Antidromic sensory conduction and segmentary motor conduction of the median nerve were studied along with the difference between median and ulnar sensory latencies. Only 84 of the 921 hands (5.2%) showed normal electrophysiological findings and 469 (50.9%) minimal changes. 343 hands (37.2%) showed signs suggestive of axonal degeneration in sensory fibers and 147 (16%) in motor ones. Of the 130 slight CTS not surgically treated, clinical manifestations persisted for one year in 118, 17 of which have normal electrophysiological parameters. Twenty six (20%) of these 130 hands got worse. Of the 105 CTS surgically treated hands, 58 continued with symptoms one year later in spite of the electrophysiological improvement in 88.6% of them. Among 588 patients hands without CTS symptoms, only 0.8% had electrophysiological signs suggesting CTS. A high yield of the electrophysiological diagnosis of the CTS is shown. Symptoms frequently persist in patients without definite nerve compression.
Valls Canals
J
J
Servicio de Neurología, Hospital Sant Pere Claver, Barcelona.
Montero
J
J
Pradas
J
J
D001369:Axons; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D004594:Electrophysiology; D005073:Evoked Potentials, Somatosensory; D006225:Hand / Q000294:innervation; D006801:Humans; D008475:Median Nerve / Q000503:physiopathology*; D009410:Nerve Degeneration / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies
Estudio electrofisiológico en 921 síndromes del túnel carpiano: su aplicación al pronóstico y tratamiento.