Electroneuromyography in the diagnosis of carpal tunnel syndrome


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The review is devoted to modern methods of electrophysiological evaluation of median nerve damage in the carpal tunnel (the so-called carpal tunnel syndrome, CTS) which is the most frequently diagnosed form of compression neuropathy of the upper extremities. Specificity and sensitivity of different methods of electromyography (EMG) in diagnostics of the disease, as well as in determining subclinical patterns of nerve involvement and indications for optimal treatment choice are demonstrated. EMG criteria of the CTS severity are provided. A protocol of EMG evaluation of patients suspected for CTS, based on most sensitive methods, is presented. The need of comprehensive electrophysiological evaluation of patients with median nerve lesions is shown, with special attention to exclusion of hereditary neuropathy. Problems of differential and false-positive diagnosis of CTS are considered.

 
 

作者简介

N. Savitskaya

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

编辑信件的主要联系方式.
Email: platonova@neurology.ru
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E. Pavlov

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
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N. Shcherbakova

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
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D. Yankevich

Research Center of Neurology, Russian Academy of Medical Sciences (Moscow)

Email: platonova@neurology.ru
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参考

  1. Команцев В.Н., Заболотных В. Методические основы клинической электронейромиографии. Руководство для врачей. СПб, 2001.
  2. American Association of Electrodiagnostic Medicine, American Academy of Neurology and American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 2002; 25: 918–922.
  3. Atroshi I., Gummesson C., Ornstein E. et al. Carpal tunnel syndrome and keyboard use at work: a population-based study. Arthritis Rheum. 2007; 56: 3620–3625.
  4. Atroshi I., Gummesson C., Johnsson R. Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome. Musculoskeletal Disord. 2003; 4: 9–11.
  5. Bird T.D. Hereditary neuropathy with liability to pressure palsies. Gene Reviews 2010; 8: 56–59.
  6. Boland R.A., Kiernan M.C. Assessing the accuracy of a combination of clinical tests for identifying carpal tunnel syndrome. J. Clin. Neurosci. 2009; 16: 929–933.
  7. Borg K., Lindblom U. Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome. Acta Neurol .Scand. 1988; 78: 537–541.
  8. Buschbacher R.M., Prahlow N.D. Manual of nerve conduction studies. 2″ed. New York: Demos Medical Publishing, 2006.
  9. Caress J.B. Technical, physiological and anatomic considerations in nerve conduction studies. In: A.S.Blum (ed). The Clinical Neurophysiology primer. Humana Press Inc, 2007.
  10. Hoitsma E., Reulen J.P.H., Baets М. et al. Small fiber neuropathy: a common and important clinical disorder. J. Neurol. Sci. 2004; 227: 119–130.
  11. Jablecki C.K., Andary M.T., Floeter M.K. et al. Second AAEM literature review of the usefulness of nerve conduction studies and needle electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 2002; 26: S1–S53.
  12. Keith M.W., Masear V., Chung K.C. et al. American Academy of Orthopaedic Surgeons Clinical Practice Guideline on diagnosis of carpal tunnel syndrome. J. Bone Joint Surg. Am. 2009; 91: 2478–2479.
  13. Kimura J. Principles and pitfalls of nerve conduction studies. Ann. Neurol. 1984; 16: 415-429.
  14. Nashed J., Hamilton-Wright A., Stashuk D.W. et al. Assessing motor deficits in compressive neuropathy using quantitative electromyography. J. NeuroEngineering Rehabil. 2010; 7: 39–45.
  15. National Institute of Neurological Diseases and Stroke (NINDS). Available from: http://www.ninds.nih.gov/disorders/carpal_tunnel/ detail_carpal_tunnel.htm. Accessed on Jun 2010.
  16. Paget J. Lectures on surgical pathology. Philadelphia: Lindsay and Blakiston, 1854.
  17. Practice parameter: electrodiagnostic studies in carpal tunnel syndrome: report of the AAEM, AAN, and AAPMR. Neurology 2002; 58: 1589–1592.
  18. Preston D., Logigian E.L. Lumbrical and interossei recording in carpal tunnel syndrome. Muscle Nerve 1992; 15: 1253–1257.
  19. Preston D.C., Shapiro B.E. Electromyography and neuromuscular disorders. Musculoskeletal Disord. 2005; 2: 25–43.
  20. Recep A., Ulvi H., Kotan D. et al. Sensitivities of conventional and new electrophysiological techniques in carpal tunnel syndrome and their relationship to body mass index. J. Brachial Plex. Peripher. Nerve Inj. 2009; 4: 12–20.
  21. Regina M., Gjevre J.A., Nair B. Suspected carpal tunnel syndrome. Do nerve conduction study results and symptoms match? Can. Fam. Physician 2010; 56: 250–254.
  22. Rempel D.M., Keir P.J., Bach J.M. Effect of wrist posture on carpal tunnel pressure while typing. J. Orthopaedic Res. 2008; 26: 1269–1273.
  23. Robinson L.R. Electrodiagnosis of carpal tunnel syndrome. Phys. Med. Rehabil. Clin. N. Am. 2007; 18: 733–746.
  24. Roquelaure Y., Ha C., Pelier-Cady M.C. et al. Work increases the incidence of carpal tunnel syndrome in the general population. Muscle Nerve 2008; 7: 30–34.
  25. Shimpei O., Kevin P.J.C. Optimal management of carpal tunnel syndrome. Int. J. Gen. Med. 2010; 3: 255–261.
  26. Tamburin S., Cacciatori C., Praitano M.L. et al. Nerve small- and large-fiber damage in carpal tunnel syndrome: A quantitative sensory testing study. J. Pain 2010; 24: 67–70.
  27. Thiago G.N., Joаo A.K. Carpal tunnel syndrome in the elderly. Nerve conduction parameters. Arq. Neuropsiquiatr. 2010; 68: 87–92.
  28. Violante F.S., Armstrong T.J., Fiorentini C. et al. Carpal tunnel syndrome and manual work: a longitudinal study. Occup. Environ Med. 2007; 49: 89–96.

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