A new clinical scale to grade the impairment of median nerve in carpal tunnel syndrome.
OBJECTIVE
In carpal tunnel syndrome (CTS) distribution of paresthesias is related to the degree of the nerve impairment. To improve the clinical ability in detecting the damage severity, we have introduced the criteria "distribution of paresthesias" in a previous clinical scale: the historical-objective scale (Hi-Ob).


METHODS
We evaluated 100 consecutive patients (40 bilateral CTS) to validate a five stages clinical scale: the Historical-objective-distribution based scale (Hi-Ob-Db). We compared the Hi-Ob-Db with a validated neurophysiological classification and with the Boston Carpal Tunnel Questionnaire (BCTQ). The BCTQ evaluates two domains, one assessing symptoms (SYMPT=patient-oriented symptom), and the other analysing "functional status" (FUNCT=patient-oriented function).


RESULTS
The positive correlation between the Hi-Ob-Db and neurophysiological findings (p<0.001, r:0.79) was stronger than correlation between the Hi-Ob and the neurophysiological classification (p<0.001, r:0.74). A linear correlation between the Hi-Ob-Db and the patient-oriented scores was observed, respectively FUNCT (p<0.003, r:0.38) and SYMPT (p<0.002, r:0.30).


CONCLUSIONS
The Hi-Ob-Db is a clinical scale which correlates with the neurophysiological impairment of the median nerve and with patient-oriented findings in patients with CTS.


CONCLUSIONS
The new scale may be useful in routine examination and for scientific purposes.
Caliandro
P
P
Institute of Neurology, Università Cattolica, Roma, Italy. p.caliandro@rm.unicatt.it
Giannini
F
F
Pazzaglia
C
C
Aprile
I
I
Minciotti
I
I
Granata
G
G
Tonali
P
P
Padua
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000145:classification* / Q000175:diagnosis* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000473:pathology* / Q000502:physiology; D020423:Median Neuropathy / Q000145:classification / Q000175:diagnosis; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D011446:Prospective Studies; D012720:Severity of Illness Index