title: The segmental palmar test in diagnosing carpal tunnel syndrome reassessed.
abstract: OBJECTIVE
  To test our hypothesis that comparing the sensory nerve conduction velocity of the median nerve across the wrist with that of the forearm is more sensitive than comparing it with that of the palm in the electrodiagnostic confirmation of carpal tunnel syndrome (CTS).
  
  
  METHODS
  One hundred and fifty seven consecutive patients with clinically defined CTS were prospectively included and electrophysiologically examined. Antidromic nerve conduction velocities were measured in 3 segments of the median nerve: forearm, wrist, and palm. Differences and ratios in nerve conduction velocities were computed between the forearm and wrist and between the palm and wrist segments.
  
  
  RESULTS
  Comparing the median nerve conduction velocities of the forearm with the wrist segment provides a greater sensitivity (79.6% and 82.8% for the second and third digit, respectively) than comparing the palm with the wrist segment (65.6% and 65.0%). Applying the ratio leads to slightly higher sensitivities for both comparisons.
  
  
  CONCLUSIONS
  The modified segmental palmar test is a sensitive, robust and easily applicable method in diagnosing CTS.
  
  
  CONCLUSIONS
  We recommend to use the median nerve sensory conduction velocity in the forearm as a reference in the segmental palmar test instead of that in the palm.
authors.affiliation: Department of Neurology and Clinical Neurophysiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. kristel_kasius@hotmail.com
authors.forename: Kristel M
authors.initials: KM
authors.lastname: Kasius
authors.forename: Franka
authors.initials: F
authors.lastname: Claes
authors.forename: Wim I M
authors.initials: WI
authors.lastname: Verhagen
authors.forename: Jan
authors.initials: J
authors.lastname: Meulstee
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D015331:Cohort Studies; D004558:Electric Stimulation; D004568:Electrodiagnosis / Q000379:methods*; D055724:Electrophysiological Phenomena; D005260:Female; D005542:Forearm / Q000294:innervation; D006225:Hand / Q000294:innervation*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology*; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014953:Wrist / Q000294:innervation