J Korean Neurol Assoc > Volume 20(1); 2002 > Article

Journal of the Korean Neurological Association 2002;20(1): 54-59.

"수근관증후군에서 전기생리학적 척도들의 민감도 비교"

이승엽, 이세진 하정상

영남대학교 의과대학 신경과학교실

"The Comparison of Sensitivities of Electrophysiological Parameters in Carpal Tunnel Syndrome"

Seung Yeop Lee

Department of Neurology, Yeungnam University College of Medicine

Abstract

"Background : Carpal tunnel syndrome (CTS) is the most common mononeuropathy encountered in clinical practice. When performing routine diagnostic nerve conduction studies (NCS) in patients with CTS, we sometimes happen to be confronted with patients who have no definite electrophysiological evidence of CTS. We therefore evaluated the diagnostic sensitivities of several parameters in NCS for CTS patients. Methods : We analyzed 187 patients (262 hands) who were diagnosed with CTS clinically and electrophysiologically for the past 4 years in this hospital. R e s u l t s : Significant abnormal findings of nerve conduction velocity (NCV) were noted in the palm to wrist (P-W) segment( 98.5%), thumb-wrist (I-W) segment (97.3%), distoproximal ratio in the third finger (95.0%), and the terminal latency (71.4%) of the median nerve. There were no statistical differences in the abnormal NCVs between the male and female groups. The sensitivity of each compartment parameters were obtained in the female groups and statistical differences were found in the sensory NCV of the P-W segment and compound nerve action potential (CNAP) amplitude of the I-W segments in patients between the ages of 40 and 60. The sensory NCV of the P-W segment was especially more significant in this age group. There were statistical differences in the amplitude of the index finger to wrist (F-W) and P-W segments between the denervated electromyography group and normal group (p<0.05). Conclusions : In clinically suspected CTS, the most sensitive tests were the sensory NCV of the P-W segment, I-W segment, and distoproximal ratio in the third finger. Therefore, the sensory NCV of the P-W segment should be performed first. If the results of this test are unremarkable, then, the next tests should include the sensory NCV of the I-W segment and the distoproximal ratio should be performed before ruling out the diagnosis of CTS.Key Words : Carpal tunnel syndrome, Median nerve, Sensitivity"