title: Second lumbrical muscle recordings improve localization in severe carpal tunnel syndrome.
abstract: OBJECTIVE
  To determine how often the second lumbrical motor potential is present when the abductor pollicis brevis (APB) motor potential is absent in severe carpal tunnel syndrome (CTS).
  
  
  METHODS
  Prospective study of consecutive patients with severe CTS and an absent motor potential from the APB.
  
  
  METHODS
  Single-center public hospital-based electromyography lab.
  
  
  METHODS
  Patients with a clinical diagnosis of CTS who had an absent median sensory response and an absent median motor response to APB on routine nerve conduction testing. Twenty-two hands of 19 patients were examined.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Presence and distal latency of motor potential to the second lumbrical.
  
  
  RESULTS
  The second lumbrical potential was present in 17 hands (77%). The distal motor latency to the second lumbrical was prolonged in all (mean, 9.1ms; normative value, <4.1ms).
  
  
  CONCLUSIONS
  Second lumbrical recordings improve localization in many patients with severe CTS when routine median sensory and motor conduction studies produce no potentials.
authors.affiliation: Division of Neurology, John H Stroger Hospital of Cook County, Chicago, IL 60612, USA. richard.brannegan@hektoen.org
authors.forename: Richard
authors.initials: R
authors.lastname: Brannegan
authors.forename: Russell
authors.initials: R
authors.lastname: Bartt
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000503:physiopathology*; D004558:Electric Stimulation; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005385:Fingers / Q000294:innervation*; D006801:Humans; D008475:Median Nerve / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000294:innervation*; D009431:Neural Conduction / Q000502:physiology; D011446:Prospective Studies; D014459:Ulnar Nerve / Q000503:physiopathology