Comparative electrophysiological techniques in the diagnosis of carpal tunnel syndrome in patients with diabetic polyneuropathy.
OBJECTIVE
To determine utility of comparative electrophysiological techniques in differentiating carpal tunnel syndrome (CTS) in the background of diabetic polyneuropathy (DPN).


METHODS
Ninety diabetic patients were classified into three groups: normal, CTS, and DPN according to nerve conduction studies (NCSs). The patients in the DPN group were divided into two subgroups of DPN and DPN-CTS according to clinical criteria. The comparative electrophysiological parameters including median-radial sensory distal latency difference (M-RSLD), median-ulnar sensory distal latency difference (M-USLD) and lumbrical-interosseous median-ulnar distal latency difference (LIMULD) were compared in subgroups of DPN, DPN-CTS and CTS.


RESULTS
Thirty-five (38.8%), 47 (52.3%), and 8 (8.9%) patients were diagnosed as CTS, DPN, and normal, respectively, according to NCS. After clinical stratification, 25 patients were diagnosed as DPN and 22 patients were diagnosed as DPN-CTS. The mean M-USLD and LIMULD values were similar in CTS and DPN-CTS groups, but larger than DPN statistically (p<0.05 for all). LIMULD, M-RSLD and M-USLD were positive in 88.4, 73 and 54% in the DPN-CTS group, respectively.


CONCLUSIONS
Electrophysiological abnormalities were common in diabetic patients and LIMULD can identify CTS in diabetic DPN patients better than M-RSLD and M-USLD.
Yagci
Ilker
I
Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation, Turkey. drilkery@yahoo.com
Gunduz
Osman Hakan
OH
Sancak
Seda
S
Agirman
Mehmet
M
Mesci
Erkan
E
Akyuz
Gulseren
G
D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D004568:Electrodiagnosis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D011446:Prospective Studies; D012720:Severity of Illness Index