title: 'Cuff Sign' a new maneuver for decision-making in patients with carpal tunnel syndrome.
abstract: BACKGROUND
  Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that results from compression of the median nerve within the carpal tunnel. In most patients, the diagnosis can be proposed based on patient history and clinical symptoms, with physical findings being attributed only in more severely affected patients. The purpose of this study is to introduce a reliable and accurate method for the proper selection of patients with mild carpal tunnel syndrome (CTS), for surgery.
  
  
  METHODS
  Electerodiagnostic studies are performed before and after placement of the cuff of the sphygmomanometer at the arm (Cuff sign), at a mean arterial pressure, for three minutes. Thirty symptomatic patients with mild findings on electrodiagnostic studies and 49 asymptomatic control hands have been included.
  
  
  RESULTS
  Fifteen patients reported good pain relief on the first postoperative day (50%), which increased to 21 on the fouteenth postoperative day (70%). The sensory latency changes were significantly higher in the pain relief group, both on the first and fourteenth postoperative days.
  
  
  CONCLUSIONS
  Considering the fact that cooperation of the patients is not necessary and the double effects of direct pressure and ischemia over the proximal parts of the median nerve leads to prolonged latencies, this test is a useful method for decision-making in patients with severe symptoms of CTS, despite the mild electrodiagnostic findings.
authors: Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Keivan
authors: K
authors: Basiri
authors: Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Saeid
authors: S
authors: Abrishamkar
authors: Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Farzad
authors: F
authors: Fatehi
authors: Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Behnaz
authors: B
authors: Ansari
authors: Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Rokhsareh
authors: R
authors: Meamar
keywords: Carpal tunnel syndrome; median nerve; pain relief scale