Electrodiagnostic evaluation of patients with carpal tunnel syndrome regarding the presence of subjective and physical findings

摘要

The aim of our study was to evaluate the changes of median nerve conduction velocities by electrodiagnostic procedure in carpal tunnel syndrome (CTS) patients with and without subjective and physical findings. We have evaluated 116 patients that were diagnosed with CTS. Subjective findings: weakness, numbness and night pain were analyzed. Further physical findings were evaluated: Tinel's sign, muscles hypotrophy and weakness according to muscle manual test (MMT). Duration of complaints was evaluated as well. Electroneurographic findings included: estimation of median nerve motor terminal latency (mMTL) and median nerve sensory terminal latency (mSTL), sensory velocity (mSV) and motor velocity (mMV). The patients who experienced night pain (p = 0.015) and those with muscles weakness on MMT (p = 0.016) had complained for significantly longer period. Statistically significant increase for mMTL values was noticed for patients with Tinel's sign (p < 0.045), present muscles hypotrophy (p < 0.001) and weakness on MMT (p < 0.001). There is significant decrease for mMV in the group with present Tinel's sign (p = 0.048), muscle hypotrophy (p = 0.003) and weakness on MMT (p = 0.002), and for mSV in the group with present muscle hypotrophy (p = 0.008) and group with weakness on MMT (p = 0.019). Multivariate logistic regressional analysis shown that only for hypotrophy, mMTL variable presents significant independent contributor (p = 0.009). For the diagnosis confirmation and treatment planning along with elecroneurography it is necessary to evaluate patients with CTS clinically, since different clinical manifestations are correlating in different degree with electroneurographic findings.