Literature review of the usefulness of nerve conduction studies and needle electromyography for the evaluation of patients with carpal tunnel syndrome -American Association of Electrodiagnostic Medicine American Academy of Neurology American Academy of Physical Medicine and Rehabilitation

Muscle and Nerve

Volumn 22, Issue 8 SUPPL. 8, 1999, Pages

[No Author Info available]

Author keywords

Carpal tunnel syndrome; Ectromyography; Literature revim; Nerve conduction study; Reference values; Sensitivity; Specificity

Indexed keywords

EID: 33748542339     PISSN: 0148639X     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (169)

1. American Association of Electrodiagnostic Medicine: Guidelines in Electrodiagnostic Medicine. Muscle Nerve 1992; 15:229-253. Background Reference Source: AAEM Consultant.
2. Baker EL, Ehrenberg RL: Preventing the work-related carpal tunnel syndrome: Physician reporting and diagnostic criteria. Ann Intern Med 1990; 112:317-319. Background Reference Source: Medline search.
3. Bhala RP, Thoppil E: Early detection of carpal tunnel syndrome by sensory nerve conduction. Electromyogr Clin Neurophysiol 1981; 21:155-164. Criteria Met (4/6: 1,2,3,4) Source: Pease, 1989. Abstract: With stimulation at the wrist, antidromic SNAPs were recorded from 50 hands in 25 healthy subjects and 36 hands of 21 CIS patients. DSL, amplitude, and duration of the SNAP were systemically evaluated, they were also compared to DMLs from previous studies. DSL was the most sensitive followed by DML and then duration of SNAP. They report 4 of 36 hands where the only abnormality was duration of SNAP (the statistics suggest that the criteria for abnormality was different for DSL and duration of SNAP).
4. Bleecker ML, Agnew J: New techniques for the diagnosis of carpal tunnel syndrome. Scan J Work Environ Health 1987; 13:385-388. Criteria Met (2/6: 2,3) Source: Medline search.
5. Bleecker ML: Medical surveillance for carpal tunnel syndrome in workers. J Hand Surg (Am) 1987; 12(5 Pt 2):845-848. Criteria Met (1/6: 1) Source: Medline search.
6. Bonebrake AR, Fernandez JE, Marley RJ, Dahalan JB, Kilmer KJ: A treatment for carpal tunnel syndrome: Evaluation of objective and subjective measures. J Manipulative Physiol Ther 1990; 13:507-520. Criteria Met (0/6) Source: Medline search.
7. Borg K, Lindblom U: Increase of vibration threshold during wrist flexion in patients with carpal tunnel syndrome. Pain 1986; 26:211-219. Criteria Met (2/6: 1,5) Source: Medline search.
8. Borg K, Lindblom U: Diagnostic value of quantitative sensory testing (QST) in carpal tunnel syndrome. Ada Neural Scand 1988; 78:537-541. Criteria Met (1/6: 1) Source: Medline search.
9. Brain WR, Wright AD, Wilkinson M: Spontaneous compression of both median nerves in the carpal tunnel. Six cases treated surgically. Lancet 1947; 1:277-282. Background Reference Source: Gelbermann, 1980.
10. Brammer AJ, Pyykklo I: Vibration-induced neuropathy. Detection by nerve conduction measurements. Scand J Work Environ Health 1987; 13:317-322. Criteria Met (0/6) Source: Medline search.
11. Braun RM, Davidson K, Doehr S: Provocative testing in the diagnosis of dynamic carpal tunnel syndrome. J Hand Surgery 1989; 14-A (2 Pt 1): 195-197. Criteria Met (2/6: 1,2) Source: Medline search.
12. Brown WF, Ferguson GG, Jones MW, Yates SK: The location of conduction abnormalities in human entrapment neuropathies. Can J Neural Sei 1976; 3:111-122. Background Reference Source: DeLean, 1988.
13. Buchthal F, Rosenfalck A, Trojaborg W: Electrophysiological findings in entrapment of the median nerve at wrist and elbow. J Neural Neurosurg Psychiatry 1974; 37:340-360. Criteria Met (6/6) Source: Palliyath, 1990. Abstract: With stimulation on the digits and recording from the palm, wrist, and elbow, orthodromic SNAPS were recorded using subdermal electrodes. Motor responses were recorded by stimulation at the wrist and recording over the APB; 190 normal controls, 117 patients with CTS, and 11 patients with median nerve compression at the elbow were evaluated. Additionally 112 patients were evaluated by needle EMG in the APB. Abnormalities in CTS patients were found in NCSs across the carpal tunnel and relatively spared or normal in other portions of the nerve. There were needle EMG abnormalities in 91% of the CTS patients evaluated (as defined by altered pattern of discharge during full effort, change in mean duration and amplitude of motor unit action potentials, increased incidence of polyphasic potentials, or spontaneous activity).
14. Buchthal F, Rosenfalck A: Sensory conduction from digit to palm and from palm to wrist in the carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1971; 34:243-252. Criteria Met (6/6) Source: Nau, 1988. Abstract: With stimulation on the digits (thumb, middle, and little finger with subdermal recording over the median nerve at the palm, wrist and elbow), orthodromic SNAPS were recorded using averaging techniques. Motor responses were evaluated with stimulation at the wrist, and elbow and subdermal recording over the APB. Ten normal subjects and 22 hospitalized patients were evaluated. Focal slowing across the carpal tunnel was seen in some patients with clinical signs of CTS in whom DML and sensory conduction from digit to wrist were normal.
15. Cannon BW, Love JG: Tardy median palsy; median neuritis; median themar neuritis amenable to surgery. Surgery 1946; 20:210-216. Background Reference Source: Gelbermann, 1980.
16. Carroll G: Comparison of median and radial nerve sensory latencies in the electrophysiological diagnosis of carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol 1987; 68:101-106. Criteria Met (6/6) Source: Medline search. Abstract: With stimulation on index finger and thumb, orthodromic SNAPS were recorded at the wrist in 100 healthy hands and 161 CTS hands. When differences in the distal latencies between the median and radial nerves were used as abnormal, 60% sensitivity was obtained. The median-radial comparison increased the yield of abnormalities in 17 of 161 hands when compared to the index DSL latency alone.
17. Casey EB, LeQuesne PM: Digital nerve action potentials in healthy subjects, and in carpal tunnel and diabetic patients. J Neural Neurosurg Psychiatry 1972; 35:612-623. Criteria Met (6/6) Source: Palliyath, 1990. Abstract: With stimulation of the middle finger, median sensory nerve conduction velocities were calculated from the onset and peak latencies of SNAPS recorded from the wrist and proximal phalanx with surface electrodes. The conduction velocities of both the digit-wrist and distal-proximal digit segments were reduced uniformly in 18 patients with diabetic polyneuropathy. In contrast, the conduction velocity of the distal-proximal digit segment was often normal while the conduction velocity of the digit-wrist segment was reduced in 16 CTS patients.
18. Cassvan A, Rosenberg A, Rivera LF: Ulnar nerve involvement in carpal tunnel syndrome. Arch Phys Med Rehabil 1986; 67:290-292. Criteria Met (1/6: 3 Source: Medline search.
19. Cassvan A, Ralescu S, Shapiro E, Moshkovski FG, Weiss J: Median and radial sensory latencies to digit I as compared with other screening tests in carpal tunnel syndrome. Am J Phys Med Rehabil 1988; 67:221-224. Criteria Met (3/6: 1,3,5) Source: Medline search.
20. Charles N, Vial C, Chauplannaz G Bady B: Clinical validation of antidromic stimulation of the ring finger in early electrodiagnosis of mild carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol 1990; 76:142-147. Criteria Met (4/6: 1,3,5,6) Source: Medline search. Abstract: The following techniques were studied: (a) orthodromic stimulation of the index finger with recording over the median nerve at the wrist, (b) antidromic SNAPs were recorded over the ring finger using ring electrodes after stimulation of the median nerve and then the ulnar nerve at the wrist, (c) DSL difference by subtracting the ulnar DSL to the ring finger from the median DSL to the ring finger, and (d) median DML with stimulation at the wrist and recording over APB. Three different groups were studied: (1) the control group with 100 hands in 60 healthy subjects; (2) 224 hands from 158 potential CIS patients; and (3) 30 hands from 30 patients with parasthesias into the middle and index fingers due to cervical spondylitic radiculopathy. They found the median-ulnar DSL difference to the ring finger the most sensitive technique followed in order by the median sensory NCV to ring finger, median sensory NCV to index finger and median DML. They report no differences between the cervical spondylitic radiculopathy group and the normal group and found no cases of abnormal median-ulnar DSL differences to the ring finger in this group (no false positives). They also report that amplitude was not a reliable parameter for the diagnosis of CTS.
21. Cho DS, MacLean IC: Comparison of normal values of median, radial and ulnar sensory latencies. Muscle Nerve 1984; 7:575. Criteria Met (0/6) (Abstract Only) Source: Redmond, 1988.
22. Cioni R, Passero S, Paradiso C, Giannini F, Battistini N, Rushworth G: Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. J Neural 1989; 236:208-213. Criteria Met (6/6) Source: Medline search. Abstract: The median, radial, and ulnar nerves were stimulated at the wrist at the horizonal line of the radial styloid and SNAPS were recorded over each finger in 375 abnormal and 56 control hands. Absolute latencies of the median nerve to thumb, index and ring fingers were recorded. Ratios comparing the median nerve to either the radial nerve or ulnar nerve were also evaluated. Using clinical criteria for the definition of CTS, they found abnormal sensory NCVs to the ring finger at 100%, middle finger 92%, index finger 80%, and thumb 64%. Amplitudes of the sensory responses were not sensitive. The ratio of latencies median index/ulnar little finger was abnormal in 93.9%, median ring/ulnar ring 95.5%, and median thumb / radial thumb 82.8%.
23. Cruz Martinez AC, Barrio M, Perez Conde MC, Gutierrez AM: Electrophysiological aspects of sensory conduction velocity in healthy adults. J Neural Neurosurg Psychiatry 1978; 41:1092-1096. Criteria Met (5/6: 1,3,4,5,6) Source: Vails, 1988. Abstract: In 47 healthy subjects, the median and ulnar nerve conduction velocity was measured from digit to palm and from palm to wrist. Ulnar nerve conduction velocity from wrist to below sulcus and from below sulcus to above sulcus. NCVs for each segment were determined from measurements of the onset latency (personal communication). The results suggest that aging causes a decrement in conduction velocity and changes the shape of evoked potentials, especially at points where nerves are frequently compressed (carpal tunnel and cubital tunnel). No CTS patients were studied.
24. Cruz Martinez A: Diagnostic yield of different electrophysiological methods in carpal tunnel syndrome (letter to editor). Muscle Nerve 1991; 183-184. Criteria Met (3/6: 1,2,3) Source: Medline search.
25. Daube JR: Percutaneous palmar median nerve stimulation for carpal tunnel syndrome, abstract. Electroencephalogr Clin Neurophysiol 1977; 43:139-140. Criteria Met (0/6) (Abstract Only) Source: Palliyath, 1990.
26. Dawson GD: The relative excitability and conduction velocity of sensory and motor nerve fibers in man. J Physiol 1956; 131:436-451. Background Reference Source: Gilliatt 1978.
27. Dawson GD, Scott JW: The recording of nerve action potentials through the skin in man. J Neural Neurosurg Psychiatry 1949; 12:259-267. Background Reference Source: Mills, 1985.
28. DeKrom MC, Knipschild PG, Kester AD, Spanas F: Efficacy of provocative tests for diagnosis of carpal tunnel syndrome (comment in Lancet 1990 Mar 24:335(8691):727). Lancet 1990 17; 335(8686):393-395. Criteria Met (3/6: 1,4,6) Source: Medline search.
29. DeLean J: Transcarpal median sensory conduction: detection of latent abnormalities in mild carpal tunnel syndrome. Can J Neural Sei 1988; 15:388-393. Criteria Met (6/6) Source: Medline search. Abstract: Median sensory studies were performed with stimulation over the index or middle finger and recording with subdermal electrodes at the midpalm and wrist over the median nerve; median motor conduction studies were performed with surface stimulation and recording electrodes over the APB in 80 hands from 43 healthy volunteers and 253 hands from 150 CTS patients. They found abnormalities in 63% of the CTS patients. Palmar latencies were most likely to be abnormal followed by wrist DSLs with wrist DML the least sensitive.
30. DiBenedetto M, Mitz M, Klingbeil GE, Davidoff D: New criteria for sensory nerve conduction especially useful in diagnosing carpal tunnel syndrome. Arch Phys Med Rehabil 1986; 67:586-589. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: This paper reports normal values in 45 hands of 30 healthy adults using rigid techniques on temperature and distance. Antidromic and orthodromic SNAPS from median, ulnar and radial nerves, wrist-to-thumb, wrist-to-index finger, wrist-to-middle finger, wrist-to-ring finger and palm-to-wrist. Latencies to onset, negative peak, amplitude, 2 measures of duration, and normal values for sideto-side differences are reported. No CTS patients were studied.
31. Dunnan JB, Waylonis GW: Wrist flexion as an adjunct to the diagnosis of carpal tunnel syndrome. Arch Phys Med Rehabil 1991; 72:211-213. Criteria Met (3/6: 1,3,4) Source: Medline search.
32. Editorial: Diagnosis of the carpal tunnel syndrome. Lancet 1985; 1:854-855. Criteria Met (0/6) Source: Golding, 1986.
33. Eklund G: A new electrodiagnostic procedure for measuring sensory nerve conduction across the carpal tunnel. Ups J Med Sei 1975; 80:63-67. Criteria Met (0/6) Source: Macleod, 1987.
34. Evans BA, Daube JR: A comparison of 3 electrodiagnostic methods of diagnosing carpal tunnel syndrome. Muscle Nerve 1984; 7:565. Criteria Met (2/6: 1,2 [abstract only]) Source: Redmond, 1988.
35. Feierstein MS: The performance and usefulness of nerve conduction studies in the orthopedic office. Orthop Clin North Am 1988; 19:859-866. Criteria Met (0/6) Source: Medline search.
36. Felsenthal G: Median and ulnar distal motor and sensory latencies in the same normal subject. Arch Phys Med Rehabil 1977; 58:297-302. Criteria Met (4/6: 1,3,5,6) Source: Jackson, 1989. Abstract: The following techniques were studied in 50 normal subjects: (a) median DML after stimulation at the wrist and recording over APB, (b) ulnar DML after stimulation at the wrist and recording over abductor digiti minimi, (c) median DSL with stimulation at the wrist and recording with ring electrodes over the index finger and (d) ulnar DSL after stimulation at the wrist and recording with ring electrodes over the little finger. Additionally side-to-side differences and median-ulnar latency differences are reported. No data on CTS patients is reported.
37. Felsenthal G: Median and ulnar muscle and sensory evoked potentials. Am J Phys Med 1978a; 57:167-182, Criteria Met (4/6: 1,3,5,6) Source: Jackson, 1989. Abstract: The following techniques were studied in 50 normal subjects: (a) CMAP potentials were recorded after stimulation at the wrist and recording over the APB, (b) CMAPs were recorded from the abductor digiti minimi after stimulation of the ulnar nerve at the wrist, (c) SNAPs were recorded from the index finger after stimulation from the median nerve at the wrist, and (d) SNAPs were recorded from ring electrodes from the little finger after ulnar nerve stimulation at the wrist. Amplitudes of the CMAP and SNAPs are reported and left-to-right comparisons and median-to-ulnar comparisons are reported. No CTS patients were studied.
38. Felsenthal G: Comparison of evoked potentials in the same hand in normal subjects and in patients with carpal tunnel syndrome. Am J Phys Med 1978; 57:228-232, Criteria Met (3/6: 3,5,6) Source: Jackson, 1989.
39. Felsenthal G, Spindler 11: Palmar conduction time of median and ulnar nerves of normal subjects and patients with carpal tunnel syndrome. Am J Phys Med 1979; 58:131-138. Criteria Met (5/6: 1,2,3,5,6) Source: Redmond, 1988. Abstract: With stimulation at the wrist and palm, antidromic SNAP latencies were determined for the median and ulnar nerves from 60 hands in 30 normal subjects and 33 patients with CTS. They found that the absolute median wrist-to-palm conduction time and the median ulnar wrist-to-digit comparison was more sensitive than the median wrist-to-digit latency. The latency ratio comparing median wrist-to-palm and wrist-to-digit latency was too variable to be useful in the diagnosis of CTS.
40. Fitz WR, Mysiw WJ, Johnson EW: First lumbrical latency and amplitude. Control values and findings in carpal tunnel syndrome. Am J Phys Med Rehabil 1990; 69:198-201. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: With stimulation at the wrist, CMAPS were recorded from the first lumbrical and APB from 44 healthy adults and 36 patients with CTS. Sensory latencies were also recorded, but not systematically reported. In CTS patients, 8% had an abnormal DML to the lumbrical with a normal DML to the APB. They did not find any cases where the latency to the lumbrical was abnormal and sensory studies were normal.
41. Fullerton PM: The effect of ischaemia on nerve conduction in the carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1963; 26:385-397. Background Reference Source: Gillian, 1990.
42. Gelberman RH, Aronson D, Weisman MH: Carpal tunnel syndrome: Results of a prospective trial of steroid injection and splinting. J Bone Joint Surg 1980; 62a: 1181-1187. Criteria Met (2/6: 1,6) Source: Borg, 1986.
43. Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH: The carpal tunnel syndrome: A study of carpal canal pressures. J Bone Joint Surg 1981; 63-A:380-383. Criteria Met (0/6) Source: Rojviroj, 1990.
44. Gellman H, Gelberman RH, Tan AM, Botte MJ: Carpal tunnel syndrome. An evaluation of the provocative diagnostic tests. J Bone Joint Surg (Am) 1986; 68:735-737. Criteria Met (1/6: 1) Source: Medline search.
45. Gillian RW, Wilson TG: A pneumatic-tourniquet test in the carpal tunnel syndrome. Lancet 1953; 2:595-597. Criteria Met (0/6) Source: Gellman, 1986.
46. Gilliatt RW, Sears TA: Sensory nerve action potentials in patients with peripheral nerve lesions. J Neural Neurosurg Psychiatry 1958; 21:109-118. Background Reference Source: Stevens, 1987.
47. Gilliatt RW: Sensory conduction studies in early recognition of nerve disorders. Muscle Nerve 1978; 1:352-359. Background Reference Source: Kimura, 1979.
48. Gilliatt RW: Chronic nerve compression and entrapment, in. Sumner AJ (ed). The Physiology of Peripheral Nerve Disease. Philadelphia, WB Saunders Co, 1980, pp 316-339. Background Reference Source: Lundborg, 1986.
49. Gilliatt RW, Meer J: The refractory period of transmission in patients with carpal tunnel syndrome. Muscle Nerve 1990; 13:445-450. Criteria Met (4/6: 1,3,4,5) Source: Medline search. Abstract: With stimulation at the wrist and recording at the finger and elbow, the refractory period of transmission (RPT) was determined between 2 successive shocks by using averaging and signal subtraction techniques. Fourteen hands from 10 CTS patients and 15 control subjects were evaluated. The RPT was abnormal in 11 out of 14 CTS patients.
50. Golding DN, Rose DM, Selvarajah K: Clinical tests for carpal tunnel syndrome: An evaluation. Br J Rheumatol 1986; 25:388-390. Criteria Met (3/6: 1,3,4) Source: Medline search.
51. Gordon CA, Bowyer BL, Johnson EW: Electrodiagnostic characteristics of acute carpal tunnel syndrome. Arch Phys Med Rehabil 1987; 68:545-548. Criteria Met (0/6) Source: Pease, 1988.
52. Gordon C, Johnson EW, Gatens PF, Ashton JJ: Wrist ratio correlation with carpal tunnel syndrome in industry. Am J Phys Med Rehabil 1988; 67:270-2'o8. Criteria Met (3/6: 1,3,5) Source: Medline search.
53. Gutmann I,: Median-ulnar communications and carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1977; 40:982-986. Criteria Met Source: Gutmann, 1986.
54. Gutmann L, Gutierrez A, Riggs J: The contribution of medianulnar communications in diagnosis of mild carpal tunnel syndrome. Muscle Nerve 1986; 9:319-321. Criteria Met (1/6: 3) Source: Rivner, 1991.
55. Hagberg M, Nystrom A, Zetterlund B: Recovery from symptoms after carpal tunnel syndrome surgery in males in relation to vibration exposure. JHandSurg (Am) 1991; 16:6671. Criteria Met (1/6: 4) Source: Medline search.
56. Healy C, Watson JD, Longstaff A, Campbell MJ: Magnetic resonance imaging of the carpal tunnel. J Hand Surg (Br) 1990; 15:243-248. Criteria Met (3/6: 1,2,3) Source: Medline search.
57. Herrick RT, Herrick SK: Thermography in the detection of carpal tunnel syndrome and other compressive neuropathies. J Hand Surg (Am) 1987; 12:943-949. Criteria Met (1/6: 1) Source: Medline search.
58. Holmgren H, Rabow L: Internal neurolysis or ligament division only in carpal tunnel syndrome. II. A 3 year follow-up with an evaluation of various neurophysiological parameters for diagnosis. Acta Neurochir (Wien) 1987; 87:44-47. Criteria Met (2/6: 1,2) Source: Medline search.
59. Holmgreen-Larsson H, Leszniewski W, Linden U, Rabow L, Thorling J: Internal neurolysis or ligament division only in carpal tunnel syndrome-results of a randomized study. Act Neurochir (Wien) 1985; 74:118-121. Criteria Met (0/6) Source: Holmgren, 1987.
60. Hughes ACR: An evaluation of 2 electrodiagnostic procedures in patients with symptoms of a carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol 1977; 43:140. Criteria Met (0/6) (abstract only) Source: AAEM Consultant.
61. Imai T, Matsumoto H, Minami R: Asymptomatic ulnar neuropathy in carpal syndrome. Arch Phys MedRehabil 1990; 71:992-994. Criteria Met (3/6: 1,3,5) Source: Medline search.
62. lyer V, Fenichel GM: Normal median nerve proximal latency in carpal tunnel syndrome: A clue to coexisting Martin-Gruber anastomosis. J Neural Neurosurg Psychiatry 1976;39:449452. Background Reference Source: AAEM Consultant.
63. Jackson D, Clifford JC: Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys MedRehabil 1989; 70:199-204. Criteria Met (6/6) Source: Medline search. Abstract: This study evaluated the following techniques: (a) median nerve stimulation in the palm and recording proximal at the wrist (8 cm), (b) sensory latency difference between median and radial stimulation at the wrist and recording on the thumb (10 cm), (c) medial-ulnar sensory latency difference with stimulation at the wrist and recording on the ring finger ( 14 cm), (d) medianulnar sensory latency difference with stimulation in the palm and recording at the wrist (8 cm), and (e) amplitude ratio between median SNAP to index finger/ulnar SNAP to the little finger. One hundred thirty-one abnormal hands in 123 subjects and 38 normal hands in 38 people were evaluated with analysis focused on the 40 hands in the mild CTS group. Symptoms were systematically recorded and reported in each patient. The median-radial latency difference to the thumb and medianulnar latency difference to ring finger was slightly more sensitive than the midpalm studies. Amplitude ratios were very insensitive.
64. Jhee WH, Oryshkevich RS, Wilcox R: Severe carpal tunnel syndrome with sparing of sensory fibers. Orthop Rev 1986; 15:103-106. Criteria Met (1/6: 4) Source: Medline search.
65. Johnson EW, Melvin JL: Sensory conduction studies of median and ulnar nerves. Arch Phys MedRehabil 1967; 48:2530. Criteria Met (5/6: 1,3,4,5,6) Source: Dunnan, 1991. Abstract: With stimulation of the middle or index finger and recording over the median nerve at the wrist, orthodromic SNAPs and DSLs were determined in 120 controls. Orthodromic ulnar SNAPs and DSL were determined after stimulation of the ring finger or little finger and recording at the wrist and 44 controls. They report cases of abnormal DSL in patients with carpal tunnel syndrome, toxic neuropathy, early diabetic neuropathy and other peripheral nerve involvement problems.
66. Johnson EW, Kukla RD, Wongsam PE, Piedmont A: Sensory latencies to the ring finger: Normal values and relation to carpal tunnel syndrome. Arch Phys MedRehabil 1981 ; 62:206208. Criteria Met (4/6: 1,3,4,5) Source: Redmond, 1988. Abstract: With stimulation at the wrist and recording over the ring finger, the median and ulnar nerve DSL were recorded across the wrist; 37 normal subjects and 18 cases of CTS were evaluated. The difference between median and ulnar DSL to the ring finger was abnormal in all 18 CTS patients.
67. Johnson EW, Sipski M, Lammertse T: Median and radial sensory latencies to digit I: Normal values and usefulness in carpal tunnel syndrome. Arch Phys Med Rehabil 1987; 68: MOHI. Criteria Met (3/6: 1,3,4) Source: Medline search.
68. Jordan SE, Greider JL Jr: Autonomie activity in the carpal tunnel syndrome. Orthop Rev 1987; 16:165-169. Criteria Met (2/6: 1,2) Source: Medline search.
69. Joynt RL: Comparison of residual latency and palmar stimulation for diagnosis of carpal tunnel syndrome. Muscle Nerve 1984; 7:565. Criteria Met (0/6) (abstract only) Source: Redmond, 1988.
70. Joynt RL: Differences in sensory conduction velocity between different sensory branches and segments of the median and ulnar nerves. Am J Phys Med Rehabil 1989; 68:210-214. Criteria Met (3/6: 1,5,6) Source: Medline search.
71. Joynt RL: Correlation studies of velocity, amplitude and duration in median nerves. Arch Phys Med Rehabil 1989; 70:477-481. Criteria Met (4/6: 1,3,5,6) Source: Medline search. Abstract: The following techniques were studied: (a) stimulation in the palm between the third and fourth metacarpals and median recording at the wrist and (b) stimulation at the wrist and CMAP recording over the ABP. Distal latencies, amplitudes, duration of response and residual latencies were evaluated; 390 patients were studied, all these were symptomatic and many of them had CTS. The results suggest that amplitude, duration, and conduction velocity are relatively poorly correlated and independent variables. There is a very high correlation between residual latency and distal motor latency, thus suggesting limited usefulness for residual latency in the diagnosis of CTS.
72. Katims JJ, Rouvelas P, Sadler BT, Weseley SA: Current perception threshold: Reproducibility and comparison with nerve conduction in evaluation of carpal tunnel syndrome. Trans Am Soc Artif Intern Organs 1989; 35:280-284. Criteria Met (2/6: 1,2) Source: Medline search.
73. Katz JN, Larson MG, Sabra A, Krarup C, Stirrat CR, Sethi R, Eaton HM, Fossel AH, Liang MH: The carpal tunnel syndrome: Diagnostic utility of the history and physical examination findings (comments in Ann Intern Med 1990 1;113:254 and
74. Ann Intern Med 1990 1;113:409
75. ). Ann Intern Med 1990; 112:321-327. Criteria Met (2/6: 1,5) Source: Medline search.
76. Katz JN, Stirrat CR, Larson MG, Fossel AH, Eaton HM, Liang MH: A self-administered hand symptom diagram for the diagnosis and epidemiologic study of carpal tunnel syndrome. J Rheumata/ 1990; 17:1495-1498. Criteria Met (3/6: 2,3,4) Source: Medline search.
77. Katz JN, Stirrat CR: A self-administered hand diagram for the diagnosis of carpal tunnel syndrome. J Hand Surg (Am) 1990; 15:360-363. Criteria Met (1/6: 1) Source: Medline search.
78. Katz JN, Larson MQ Fossel AH, Liang MH: Validation of a surveillance case definition of carpal tunnel syndrome (comment in Am J Public Health 1991 Feb;81:161-2). Am J Public Health 1991; 81:189-193. Criteria Met (2/6: 1,2) Source: Medline search.
79. Kemble F: Electrodiagnosis of the carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1968; 31:23-27. Criteria Met (5/6: 1,2,4,5,6) Source: Winn, 1989. Abstract: With stimulation over thumb, index, middle, and ring fingers and recording over the median nerve at the wrist and elbow, orthdromic SNAPS and CMAPS to the APB were determined in 120 hands in 66 female patients with CTS. They found that the DSL was more likely to be abnormal than DML.
80. Kim LYS: Palmar digital nerve stimulation to diagnose carpal tunnel syndrome. Orthop Rev 1983; 59-63. Criteria Met (4/6: 1,3,5,6) Source: Joynt, 1989. Abstract: With stimulation in the midpalm and recording at the wrist, median and ulnar distal latencies and median-ulnar distal latency differences were determined in 66 hands in 33 normal control subjects and 50 hands in 39 mild CTS patients. Mild CTS was defined as patients who had symptoms who were highly suggestive of CTS, but had normal DSL between the finger and wrist. Sixty percent of these mild CTS patients were abnormal by the median-ulnar difference criteria (greater than or equal to 0.4 ms).
81. Kimura J: Collision technique. Physiologic block of nerve impulses in studies of motor nerve conduction velocity. Neurology 1976; 26:680-682. Background Reference Source: Kimura 1978.
82. Kimura J, Murphy MJ, Varda DJ: Electrophysiological study of anomalous innervation of intrinsic hand muscles. Arch Neural 1976; 33:842-844. Background Reference Source: Gutmann, 1986.
83. Kimura J: A method for determining median nerve conduction velocity across the carpal tunnel. J Neural Sei 1978; 38:1-10. Criteria Met (5/6: 1,2,3,5,6) Source: Palliyath, 1990. Abstract: With stimulation at the wrist and midpalm and recording SNAPs over the index finger and CMAPs from the APB, NCVs were determined across the carpal tunnel for both motor and sensory nerves; 50 hands from 25 control subjects and 20 hands from 13 patients with mild CTS were evaluated. The motor and sensory NCV across the carpal tunnel were more likely to be abnormal than conventional DSLs and DMLs determined from the wrist.
84. Kimura J: The carpal tunnel syndrome: Localization of conduction abnormalities within the distal segment of the median nerve. Brain 1979; 102:619-635. Criteria Met (6/6) Source: Shurr, 1986. Abstract: With stimulation at the wrist and palm, orthodromic SNAPS were recorded over the index finger and median CMAP from the wrist to APB were recorded from 122 hands from 61 normal subjects and 172 hands from 105 CTS patients. Sixty-one percent of the median CMAPS were abnormal, 63% of the wrist-to-finger latencies were abnormal and 81% of the wrist to palm latencies were abnormal. They also reported cases where 1 cm inching stimulation across the carpal tunnel was abnormal in patients with otherwise normal studies.
85. Kimura I, Ayyar DR: The carpal tunnel syndrome: Electrophysiological aspects of 639 symptomatic extremities. Electromyogr Clin Neurophysiol 1985; 25:151-164. Criteria Met (4/6: 1,2,3,5) Source: Mortier, 1988. Abstract: The following techniques were studied: (a) with stimulation at the elbow, wrist and mid-palm, orthodromic DSL were determined to the index finger, (b) DMLs were determined to the APB after stimulation at the wrist and elbow, and (c) electromyography in 639 symptomatic hands from 438 CTS patients and 175 extremities of 148 normal subjects. There was a relative slowing of the sensory NCV across the carpal tunnel as compared to the forearm in 100% of the patients with CTS. This was more sensitive than the median DSL and DML. Forty percent of the patients had abnormalities on needle EMG with 21.7% having positive sharp waves or fibrillations.
86. Kopell HP, Goodgold J: Clinical and electrodiagnostic features of carpal tunnel syndrome. Arch Phys Med Rehabil 1968; 49:371-376. Criteria Met (2/6: 1,2) Source: Louis, 1987.
87. Koskimies K, Farkkila M, Pyykko I, Jantti V, Aatola S, Starck J, Inaba R: Carpal tunnel syndrome in vibration disease. Br J Ind Med 1990; 47:411-416. Criteria Met (3/6: 1,3,4) Source: Medline search.
88. Kraft GH, Halvorson GA: Median nerve residual latency: Normal value and use in diagnosis of carpal tunnel syndrome. Arch Phys Med Rehabil 1983; 64:221-226. Criteria Met (4/6: 1,3,5,6) Source: Bleecker, 1987. Abstract: With stimulation at the elbow and wrist and recording over the ABP, DMLs and forearm NCVs were determined in 100 normal subjects and 3 CIS patients. The residual latency (DML - distance between stimulation and recording electrodes in mm / forearm NCV in m/s). They present 3 cases where the residual latency was the only abnormality found.
89. Kremer M, Gillian RW, Golding JSR, Wilson TG: Acroparaesthesiae in carpal tunnel syndrome. Lancet 1953; 2:590-595. Background Reference Source: Phalen 1966.
90. Lambert EH : Diagnostic value of electrical stimulation of motor nerves. Electroencephalogr Clin Neurophysiol 1962; 22 (suppl):9-16. Background Reference Source: Kimura 1985.
91. Lauritzen M, Liguori R, Trojaborg W: Orthodromic sensory conduction along the ring finger in normal subjects and in patients with a carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol 1991; 81(l):18-23. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: With stimulation of the ring finger using ring electrodes and needle electrode recording with averaging at the wrist over the median and ulnar nerves, DSLs and median-ulnar differences were recorded in 23 normal volunteers and 38 CTS patients. Their findings suggest that the median-ulnar orthodromic DSL difference from the ring finger was a useful screening technique in the diagnosis of CTS, but did not identify every patient when compared to stimulation of thumb and/or middle finger.
92. Logigian EL, Busis NA, Berger AR, Bruynincky F, Khalil N, Shahani BT, Young RR: Lumbrical sparing in carpal tunnel syndrome: Anatomic, physiologic, and diagnostic implications. Neurology 1987; 37:1499-1505. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: With stimulation at the wrist, simultaneous recording of CMAP to the second lumbrical and APB were recorded in 61 patients with CTS (as defined by electrophysiologic criteria) and in 16 normal subjects. They found that the lumbrical distal latency was relatively spared when compared to the distal latency to the APB and that this may be a sensitive test that could be used in addition to other tests for the diagnosis of CTS. They also found that it was not specific for CTS since it occasionally was abnormal in more proximal lesions of the median nerve.
93. Loong SC, Seah CS: Comparison of median and ulnar sensory nerve action potentials in the diagnosis of the carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1971; 34:750-754. Criteria Met (5/6: 1,2,3,5,6) Source: Macleod, 1987. Abstract: With stimulation at the index and little fingers and recording at the wrist over the median and ulnar nerves, DSL and SNAP amplitudes were recorded in 30 healthy female subjects and 22 hands in 15 CTS patients. They found that the median-to-ulnar SNAP amplitude ratio of less than 1 was a sensitive test in the diagnosis of CTS and particularly useful in patients who showed a normal DML and DSL.
94. Loong SC: The carpal tunnel syndrome: A clinical and electrophysiological study of 250 patients. Proc Aust Assoc Neural 1977; 14:51-62. Criteria Met (3/6: 1,2,6) Source: Holmgren, 1987.
95. Louis DS, Hankin FM: Symptomatic relief following carpal tunnel decompression with normal electroneuromyographic studies (retracted by Hankin and Louis in 2 subsequent issues, Orthopedics 1988; 11:532 and
96. Orthopedics 1988; 11:1244).
97. Orthopedics 1987; 10:434-436. Criteria Met (1/6: 2) Source: Medline search.
98. Luchetti R, Schoenhuber R, Landi A: Localized nerve damage recorded intraoperatively in carpal tunnel syndrome. Electromyogr Clin Neurophysiol 1988; 28:379-383'. Criteria Met (3/6: 1,3,5) Source: Medline search.
99. Lundborg G Lie-Stenstrom AK, Sollerman C, Stromberg T, Pyykko I: Digital vibrogram: A new diagnostic tool for sensory testing in compression neuropathy. J Hand Surg (Am) 1986; 11:693-699. Criteria Met (3/6: 1,2,3) Source: Medline search.
100. Macdonald G, Robertson MM, Erickson JA: Carpal tunnel syndrome among California dental hygienists. Dent Hyg (Chic) 1988; 62:322-327. Criteria Met (2/6: 1,2) Source: Medline search.
101. Macdonell RA, Schwanz MS, Swash M: Carpal tunnel syndrome: Which finger should be tested? An analysis of sensory conduction in digital branches of the median nerve. Muscle Nerve 1990; 13:601-606. Criteria Met (3/6: 1,2,3) Source: Medline search.
102. MacLean 1C, Sik Cho D: Carpal tunnel syndrome: A comparison of distal sensory latencies of median and radial nerves. Muscle Nerve 1981 ; 4:444. Criteria Met (0/6) (Abstract Only) Source: Rivner, 1991.
103. Macleod WN: Repeater F-waves: A comparison of sensitivity with sensory antidromic wrist-to-palm latency and distal motor latency in the diagnosis of carpal tunnel syndrome. Neurology 1987; 37:773-778. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: With stimulation at the wrist and recording of F waves over the APB, the frequency of repeater F waves (identical recurring F waves in latency, configuration, and amplitude) was determined by measuring 100 supermaximal shocks; 209 healthy hands and 147 entrapped median nerves were evaluated. The repeater F waves was compared to the sensory 1 cm DSL inching latency across the wrist. A high percent repeater F-wave value was considered indicative of CTS and the sensitivity approaches that of the sensory antidromic inching technique across the carpal tunnel.
104. Marin EL, Vernick S, Friedmann LW: Carpal tunnel syndrome: Median nerve stress test. Arch Phys Med Rehabil 1983; 64:206-208. Criteria Met (5/6: 1,2,3,5,6) Source: Borg, 1986. Abstract: With median stimulation at the wrist and recording over the APB and ring electrodes to the index finger, DML and DSL were obtained from the median nerve in the neutral position, then in extreme tolerable extension at 5 minutes and 10 minutes followed by the testing in the extreme tolerable flexion position after 5 and 10 minutes. An orthosis was devised to enable the wrist to be held in extreme tolerable extension which ranged from 45E-85E and extreme tolerable flexion which ranged from 45E-90E. Fourteen hands in 14 patients who had CTS and 12 hands from 12 volunteers were evaluated. Of the 14 patients, 5 of these had normal DSL and DML latencies in the neutral position. Three of these 5 showed an increase in DSL from the upper range of normal to above normal following extension or flexion.
105. Marinacci AA: Comparative value of measurement of conduction velocity and electromyography in the diagnosis of carpal tunnel syndrome. Arch Phys Med Rehabil 1964; 45:548554. Criteria Met (4/6: 1,2,3,5) Source: Nathan, 1988. Abstract: With stimulation at the wrist, elbow and axilla, and recording over the APB, motor NCVs and DMLs were determined in 204 patients having CTS and 64 control subjects. Needle EMG was also performed in this group; 70% of CTS cases had abnormal wrist DML and the needle EMG was abnormal in 96% of the cases (fibrillations, polyphasic units, and large amplitude motor units). Sensory latencies were also recorded in 23 CTS patients.
106. Marsh DR: Use of a wheel esthesiometer for testing sensibility in the hand. J Hand Surg (Br) 1986; 11:182-186. Criteria Met (3/6: 1,2,3) Source: Medline search.
107. Mavor H, Shiozawa R: Antidromic digital and palmar nerve action potentials. Electroencephalogr Clin Neurophysiol 1971 ; 30:210-221. Criteria Met (5/6: 1,3,4,5,6) Source: Buchthal, 1974. Abstract: With stimulation at the elbow and wrist and recording over the middle finger, SNAPs and DSLs from the median nerve were recorded in 21 normal subjects. With stimulation over the ulnar nerve at the elbow and wrist, antidromic SNAPs and DSLs were recorded in 13 normal subjects. No CTS patients were studied.
108. Mayer RF: Nerve conduction studies in man. Neurology 1962; 12:733-744. Criteria Met (5/6: 1,3,4,5,6) Source: Kraft, 1983. Abstract: The following techniques were studied in 64 normal subjects and 31 diabetics without peripheral neuropathy: (a) stimulation in axilla, above elbow and wrist with recording of the CMAP over the APB. Surface and concentric needle electrodes were used, (b) with stimulation in the axilla, above the elbow and wrist, SNAPs were recorded from digital nerves using surface and needle electrodes, (c) ulnar, (d) peroneal, (e) tibial, and (f) H reflex. They found a slight decrease in NCV in patients older than 50, and in patients with diabetes mellitus without clinical signs of peripheral neuropathy. No CTS patients were studied.
109. Melvin JL, Harris DH, Johnson EW: Sensory and motor conduction velocities in the ulnar and median nerves. Arch Phys Med Rehabil 1966; 47:511-519. Criteria Met (4/6: 1,3,5,6) Source: Joynt, 1989. Abstract: The following techniques were studied: (a) orthodromic SNAPs were recorded from the median nerve at the wrist and elbow, (b) orthodromic SNAPs were recorded from the ulnar nerve after stimulation of the ring and little fingers and recording over the wrist and elbow, (c) antidromic SNAPs were recorded from the median and ulnar nerve after reversing the electrodes for the orthodromic SNAPs, (d) median CMAPs recording over the opponens pollicus, and (e) ulnar CMAP over the abductor digiti quinti. The orthodromic NCVs were determined in 48 normal persons, motor conduction NCVs were determined in 47 normal people and antidromic SNAPs were completed in 36 normal people. No CTS patients were studied. They found there was no significant difference between orthodromic and antidromic sensory NCVs and that the fastest afferent sensory NCVs were faster than the fastest efferent motor fibers.
110. Melvin JL, Schuchmann JA, Lanese RR: Diagnostic specificity of motor and sensory nerve conduction variables in the carpal tunnel syndrome. Arch Phys Med Rehabil 1973; 54:69-74. Criteria Met (5/6: 1,2,3,5,6) Source: Redmond, 1988. Abstract: With stimulation at the wrist and recording CMAP over the APB and SNAP over the index and middle finger, latency, velocities, and amplitudes were determined from 24 normal volunteers and 19 patients with CTS. They found that the DSL followed by the DML were the best tests and that sensory duration, sensory amplitude, motor amplitude, and motor duration were not sensitive.
111. Merchut MP, Kelly MA, Toleikis SC: Quantitative sensory thresholds in carpal tunnel syndrome. Electromyogr Clin Neurophysiol 1990; 30:119-124. Criteria Met (5/6: 1,2,3,4,6) Source: Medline search. Abstract: Twenty-eight hands from 23 patients with CTS as defined by 1 or more of these abnormal NCSs; orthodromic DSL median-ulnar difference from ring finger-to-wrist, palm-to-wrist median DSL, fingerto-wrist median DSL, or DML from the wrist-to-APB. Quantitative sensory threshold (QST) testing was done using vibration thresholds and thermal sensitivity thresholds comparing the index to little finger in 23 age matched control subjects. Abnormal QST was found in only 3 of the 28 symptomatic hands (11%) and was found to be much less sensitive than NCSs.
112. Merhar GL, Clark RA, Schneier HJ, Stern PJ: High-resolution computed tomography of the wrist in patients with carpal tunnel syndrome. Skeletal Radial 1986; 15:549-552. Criteria Met (3/6: 1,3,6) Source: Medline search.
113. Meyers S, Gros D, Sherry B, Vermeire P: Liquid crystal thermography: Quantitative studies of abnormalities in carpal tunnel syndrome (comments in Neurology 1990;40:1146). Neurology 1989; 39:1465-1469. Criteria Met (2/6: 1,2) Source: Medline search.
114. Mills KR: Orthodromic sensory action potentials from palmar stimulation in the diagnosis of carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1985; 48:250-255. Criteria Met (5/6: 1,3,4,5,6) Source: Golding, 1986. Abstract: While
115. Molitor PJ: A diagnostic test for carpal tunnel syndrome using ultrasound. J Hand Surg (Br) 1988; 1340-41. Criteria Met (3/6: 1,3,5) Source: Medline search.
116. Monga TN, Laidlow DM: Carpal tunnel syndrome measurement of sensory potentials using ring and index fingers. Am J Phys Med 1982; 61:123-129. Criteria Met (4/6: 1,2,3,5) Source: Redmond, 1988. Abstract: With stimulation of the fourth digit (D4), orthodromic SNAPs were simultaneously recorded at the wrist over the median and ulnar nerves in 15 control subjects and 30 CTS patients and the results compared to median sensory studies with stimulation of the second digit (D2). The D4 SNAP was absent or the peak latency prolonged more frequently than the D2 SNAP in patients with CTS.
117. Monga TN, Shanks GL, Poole BJ: Sensory palmar stimulation in diagnosis of carpal tunnel syndrome. Arch Phys Med Rehabil 1985; 66:598-600. Criteria Met (5/6: 1,2,3,5,6) Source: Jackson, 1989. Abstract: The following techniques were studied: (a) ring stimulation over the index and little fingers and recording at the wrist over the median and ulnar nerve, (b) median palm stimulation and recording at the wrist, and (c) wrist stimulation over median and ulnar nerves and recording over the APB and ADM were evaluated in 36 hands in 22 CTS patients and 22 normal patients. They found the palm-to-wrist stimulation to be abnormal in 88%, the median index finger DSL (in 86%), median-ulnar finger DSL comparison (in 81%), and median DML (in 81%).
118. Mortier G, Deckers K, Dijs H, Vander Auwera JC: Comparison of the distal motor latency of the ulnar nerve in carpal tunnel syndrome with a control group. Electromyogr Clin Neumphysiol 1988; 28:75-77. Criteria Met (3/6: 1,3,5) Source: Medline search.
119. Narkas AD: The role of thoracic outlet syndrome in the double crush syndrome. Am Hand Surg 1990; 9:331-340. Criteria Met (1/6: 2) Source: Medline search.
120. Nathan PA, Meadows KD, Doyle LS: Sensory segmental latency values of the median nerve for a population of normal individuals. Arch Phys Med Rehabil 1988; 69:499-501. Criteria Met (6/6) Source: Medline search. Abstract: With stimulation at I cm intervals at the wrist and across the carpal tunnel and recording over the middle finger, 70 normal hands and 54 CTS hands were evaluated for relative sensitivity and specificity at 2 levels of abnormality. At 0.5 ms abnormality, the specificity was 97% and sensitivity was 54%. At 0.4 ms or greater, the sensitivity improved to 81% and specificity dropped to 81%. The positive predictive value at 0.5 ms was 93% and decreased to 77% at the 0.4 ms abnormality.
121. Nathan PA, Meadows KD, Doyle LS: Relationship of age and sex to sensory conduction of the median nerve at the carpal tunnel and association of slowed conduction with symptoms. Muscle Nerve 1988; 11:1149-1153. Criteria Met (3/6: 1,2,4) Source: Medline search.
122. Nathan PA, Srinivasan H, Doyle LS, Meadows KD: Location of impaired sensory conduction of the median nerve in carpal tunnel syndrome. J Hand Surg (Br) 1990; 15:89-92. Criteria Met (6/6) Source: Medline search. Abstract: Stimulation in 1cm segments across the carpal tunnel was performed from 2 cm proximal to the distal wrist crease (DWC) to 6 cm distal and SNAP latencies were recorded over the middle finger in 70 normal and 217 CTS hands. The focal areas of slowing were reported with the most common area of slowing 3 to 4 cm distal to the DWC with slowing proximal to the DWC being unusual.
123. Nau HE, Lange B, Lange S: Prediction of outcome of decompression for carpal tunnel syndrome. J Hand Surg (Br) 1988; 13:391-394. Criteria Met (1/6: 3) Source: Medline search.
124. Nielsen VK: Sensory and motor nerve conduction in the median nerve in normal subjects. Acta Med Scand 1973; 194:435-443. Criteria Met (5/6: 1,3,4,5,6) Source: Buchthal, 1974. Abstract: Orthodromic SNAPs were recorded over the median nerve using needle electrodes at the wrist and elbow after stimulation of the thumb and middle fingers. CMAPs were recorded with concentric needle electrodes placed in the endplate zone of the APB after stimulation at the wrist and elbow. NCVs were determined for 28 male and 20 female normal subjects aged 16 to 62 years. There was no significant difference in NCV between male and female subjects. There was a decrease in NCV with increasing age. No CTS patients were studied.
125. Occupational Disease Surveillance: Carpal tunnel syndrome. MMWR Morb Mortal Wkly Rep 1989; 38:485-489. Background Reference Source: Baker, 1990.
126. Osborn JB, Newell KJ, Rudney JD, Stoltenberg JL: Carpal tunnel syndrome among Minnesota dental hygienists. J Dent Hyg 1990; 64(2):79-85. Criteria Met (2/6: 1,2) Source: Medline search.
127. Palliyath SK., Holden L: Refractory studies in early detection of carpal tunnel syndrome. Electromyogr Clin Neurophysiol 1990; 30:307-309. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: Using paired stimuli and varying the inter-stimulus interval, the absolute refractory period (ARP) and relative refractory period (RRP), were determined in 10 patients with mild electrophysiologic changes suggestive of CTS. They found that the sensory RRP was sensitive in diagnosing early CTS.
128. Pavesi G, Olivier! MF, Misk A, Mancia D: Clinicalelectrophysiological correlations in the carpal tunnel syndrome, ltd J Neural Sei 1986; 7:93-96. Criteria Met (3/6: 2,3,5) Source: Medline search.
129. Pease WS, Cunningham ML, Walsh WE, Johnson EW: Determining neurapraxia in carpal tunnel syndrome. Am J Phys Med Rehabil 1988; 67:117-119. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: With needle stimulation at the wrist and midpalm, CMAPS were recorded over the APB in 25 CTS patients and 23 healthy asymptomatic persons. They found a significant difference in the amplitude of the CM AP in the CTS group when compared to the control group. They propose that this is evidence for conduction block (neurapraxia) in CTS.
130. Pease WS, Cannell CD, Johnson EW: Median to radial latency difference test in mild carpal tunnel syndrome. Muscle Nerve 1989; 12:905-909. Criteria Met (4/6: 1,3,5,6) Source: Medline search. Abstract: The following techniques were studied: (a) antidromic DSL median radial differences to the thumb, (b) antidromic DSL after stimulation at the wrist and recording from the third digit, (c) median mid-palmar DSL compared as a ratio of the wrist to middle finger DSL, (d) median ulnar DSL latency difference between the ulnar SNAP recorded from the little finger after stimulation at the wrist and the median DSL after stimulation at the wrist and recording from the middle finger, and (e) median motor DML after recording from the APB after stimulation at the wrist. Three hundred thirty-three symtomatic hands in 262 patients were initially evaluated with subgroups of patients with CTS evaluated with different tests. The median radial DSL difference and median ulnar DSL difference were most likely to be abnormal followed by median DSL then the palm-to-wrist DSL latency ratio and lastly the DML.
131. Pease WS, Lee HH, Johnson EW: Forearm median nerve conduction velocity in carpal tunnel syndrome. Electromyogr Clin Neurophysiol 1990; 30:299-302. Criteria Met (4/6: 1,3,4,5) Source: Medline search. Abstract: The NCV of the median nerve in the forearm was determined by 2 methods: (a) stimulation in the forearm and recording the nerve action potential at the wrist, and (b) stimulation at the wrist and elbow with recording over the APB, in 21 CTS patients and 16 control subjects. They found that the forearm NCV was slowed in the CTS group using either technique. The authors have proposed that this suggests that there is proximal nerve dysfunction as a result of median nerve compression in the carpal tunnel.
132. Peterson GW, Will AD: Newer electrodiagnostic techniques in peripheral nerve injuries. Orthop Clin North Am 1988; 19:1325. Criteria Met (0/6) Source: Narkis, 1990.
133. Phalen OS: The carpal tunnel syndrome: Clinical evaluation of 598 hands. Clin Orthop 1972; 83:29-40. Background Reference Source: Katz 1990 (J Rheumatology).
134. Phalen GS, Gardner WJ, LaLonde AA: Neuropathy of the median nerve due to compression beneath the transverse carpal ligament. J Bone Joint Surg 1950; 32-A:109-112. Background Reference Source: Braun, 1989.
135. Phalen GS: The carpal tunnel syndrome: Seventeen years' experience in diagnosis and treatment of 654 hands. J Bone Joint Surg 1966; 48:211-228. Criteria Met (1/6: 2) Source: Meyers, 1989.
136. Plaja J: Comparative value of different electrodiagnostic methods in carpal tunnel syndrome. Scan JRehabil Med 1971 ; 3:101-108. Criteria Met (4/6: 1,3,5,6) Source: Joynt, 1989. Abstract: The following techniques were studied: (a) CMAP potentials were recorded after stimulation at the wrist and recording with coaxial needle electrodes, (b) orthodromic SNAPs with stimulation over the index finger and recording with surface electrodes at the wrist, (c) needle EMG using a coaxial needle, (d) strength/duration curves and chronaxy. Fifty-six cases of CTS and 20 normal subjects were evaluated. Sensory latencies were more likely to be abnormal than the other techniques measured.
137. Preswick G: The effect of stimulus intensity in motor latency in carpal tunnel syndrome. J Neural Neurosurg Psychiatry 1963; 26:398-401. Criteria Met (5/6: 1,3,4,5,6) Source: Loong, 1971. Abstract: With stimulation at the wrist and coaxial needle electrode recording from the APB, DMLs were recorded at super-maximal stimulation and threshold stimulation in 29 CTS hands from 25 patients and 25 control subjects. Over 80% of the patients were identified with an abnormality either with super-maximal stimulation or threshold stimulation. Threshold stimulation was more sensitive than super-maximal stimulation.
138. Redmond MD, Rivner MH: False positive electrodiagnostic tests in carpal tunnel syndrome. Muscle Nerve 1988; 11:511518. Criteria Met (5/6: 1,3,4,5,6) Source: Medline search. Abstract: Several techniques were evaluated in a normal population using literature norms to assess for specificity in 100 hands of 50 normal subjects. Fifteen percent of the hands (30% of people) exhibited an abnormal median-to-ulnar sensory amplitude ratio, 8% of hands (14% of people) had abnormal residual latencies, and 4% of hands (8% of people) had prolonged median-ulnar palm to wrist latency (8 cm) differences. They suggested a more conservative abnormality of >0.5 ms between median and ulnar nerve for midpalm stimulation to avoid false positive tests for CTS. No CTS patients were studied.
139. Rivner MH: Carpal tunnel syndrome: A critique of "newer" nerve conduction techniques. AAEM Course D 1991. Criteria Met (2/6: 2,6) Source: AAEM Consultant.
140. Rojviroj S, Sirichativapee W, Kowsuwon W, Wongwiwattananon J, Tammanthong N, Jeeravipoolvarn P: Pressures in the carpal tunnel. A comparison between patients with carpal tunnel syndrome and normal subjects. J Bone Joint Surg (Br) 1990; 72: 516-518. Criteria Met (3/6: 1,3,6) Source: Medline search.
141. Rosenberg JN: Anterior interosseous/median nerve latency ratio. Arch Phys Med Rehabil 1990; 71:228-230. Criteria Met (4/6: 1,3,5,6) Source: Medline search. Abstract: With stimulation at the antecubital fossa and simultaneous recording over the APB and pronator quadratus (needle electrode) DMLs were determined from 100 anterior interosseous nerves in 61 normal volunteers, 5 patients with anterior interosseous syndrome, and 35 patients with CTS. The results show abnormal ratios for both CTS and anterior interosseous syndrome.
142. Schwartz MS, Gordon JA, Swash M: Slowed nerve conduction with wrist flexion in carpal tunnel syndrome. Ann Neural 1980; 8:69-71. Criteria Met (4/6: 1,2,4,5) Source: Golding, 1986. Abstract: DMLs from the wrist to APB and DSLs from the index finger to the wrist were determined in 32 hands in 20 patients and 10 control subjects. The latencies were determined before and after 2 minutes of full voluntary wrist flexion (Phalen's maneuver). They found that the DSL or DML increased by greater than 0.2 ms in 16 out of 32 CTS patients and was not greater than 0.1 ms in normals. In 2 CTS patients the only abnormality was the increase in distal latencies after Phalen's maneuver. Temperature differences before and after wrist flexion were not reported.
143. Seror P: Phalen's test in the diagnosis of carpal tunnel syndrome. J Hand Surg 1988; 13-B:383-385. Criteria Met (3/6: 1,2,6) Source: Medline search.
144. Seror P: Tinel's sign in the diagnosis of carpal tunnel syndrome. J Hand Surg 1987; 12-B :364-365. Criteria Met (3/6: 1,2,6) Source: Medline search.
145. Seror P: Comparison of the distal motor latency of the first dorsal interosseous with abductor pollices brevis. Report of 200 cases. Electromyogr Clin Neurophysiol 1988; 28:341-345. Criteria Met (1/6: 1) Source: Medline search.
146. Shahani BT, Young RR, Potts F, Maccabee P: Terminal latency index (TLI) and late response studies in motore neuron disease (MND), peripheral neuropathies and entrapment syndromes (1979). Acta Neural Scand [Suppl] 73:118 Criteria Met (0/6) (abstract only) Source: Stevens, 1987.
147. Shurr DG, Blair WF, Bassett G: Electromyographic changes after carpal tunnel release. J Hand Surg (Am) 1986; 11:876880. Criteria Met (2/6: 1,2) Source: Medline search.
148. Silverstein B, Fine L, Stetson D: Hand-wrist disorders among investment casting plant workers. J Hand Surg (Am) 1987; 12:838-844. Criteria Met (0/6) Source: Medline search.
149. Simpson JA: Electrical signs in the diagnosis of carpal tunnel and related syndromes. J Neural Neurosurg Psychiatry 1956; 19:275-280. Criteria Met (2/6: 3,5) Source: Palliyath, 1990.
150. So YT, Olney RK, Aminoff MJ: Evaluation of thermography in the diagnosis of selected entrapment neuropathies (comments in Neurology 1989;39:1003-1005). Neurology 1989; 39:1-5. Criteria Met (2/6: 1,2) Source: Medline search.
151. Spindler HA, Dellon AL: Nerve conduction studies and sensibility testing in carpal tunnel syndrome. J Hand Surg 1982; 7:260-263. Criteria Met (3/6: 2,3,5) Source: Jordan, 1987.
152. Stevens JC: AAEE minimonograph #26: The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1987; 10:99-113. Criteria Met (4/6: 3,4,5,6) Source: Medline search. Abstract: The author presents (1) the electrodiagnostic findings in 505 cases of CTS evaluated at the Mayo Clinic from 1961-1980, (2) normal values for median and ulnar sensory and motor conduction, (3) an EDX protocol for evaluation of CTS, and (4) a protocol to identify Martin-Gruber anastomosis.
153. Stevens JC, Sun S, Beard CM, O'Fallon WM, Kurland LT: Carpal tunnel syndrome in Rochester, Minnesota, 1961-1980. Neurology 1988; 38:134-138. Background Reference Source: Medline search.
154. Steward JD, Eisen A: Tinel's sign and the carpal tunnel syndrome. Br Med J 1978; 2:1125-1126. Criteria Met (1/6: 3) Source: Golding, 1986.
155. Szabo RM, Gelberman RH, Dimick MP: Sensibility testing in patients with carpal tunnel syndrome. J Bone Joint Surg 1984; 66A:60-64. Criteria Met (1/6: 1) Source: Borg, 1988.
156. Tackmann W, Lehman HJ: Relative refractory period of median nerve sensory fibers in the carpal tunnel syndrome. Ear Neural 1974; 12:309-316. Criteria Met (4/6: 1,2,4,5) Source: Palliyath, 1990. Abstract: With stimulation on the index finger and recording at the wrist, the relative median nerve refractory period was determined with paired stimuli in 11 hands of eight CTS patients and 12 hands of eight healthy controls. They found the relative refractory period more likely to be prolonged in patients with CTS as opposed to normal subjects.
157. Tackmann W, Kaeser HE, Magun HG: Comparison of orthodomic and antidromic sensory nerve conduction velocity measurement in the carpal tunnel syndrome. J Neural 1981 ; 224:257-266. Criteria Met (6/6) Source: Uncini, 1989. Abstract: Using ring electrodes on the middle finger and subdermal electrodes at the midpalm and wrist, orthodromic and antidromic SNAP latencies were recorded from 56 hands from 50 CTS patients and 32 hands from 32 healthy subjects. They report no significant differences in latencies of orthodromic and antidromic recordings and that palmar latencies are more likely to be abnormal in CTS than digit latencies.
158. Thomas PK: Motor nerve conduction in carpal tunnel syndrome. Neurology 1960; 10:1045-1050. Criteria Met (5/6: 1,2,3,5,6) Source: Wiederholt, 1970. Abstract: With coaxial needle electrorecording over the APB, stimulation at the wrist, elbow, and axilla, CMAPs and DMLs were recorded over the APB in 95 CTS patients and 50 control subjects. The DML was prolonged in approximately two-thirds of the CTS patients.
159. Thomas JE, Lambert EH, Cseuz KA: Electrodiagnostic aspects of the carpal tunnel syndrome. Arch Neural 1967; 16:635-641. Criteria Met (3/6: 3,5,6) Source: Nau, 1988.
160. Uncini A, Lange DJ, Solomon M, Soliven B, Meer J, Lovelace RE: Ring finger testing in carpal tunnel syndrome: A comparative study of diagnostic utility (comments in Muscle Nerve 1990;13:560). Muscle Nerve 1989; 12:735-741. Criteria Met (4/6: 1,2,3,5) Source: Medline search. Abstract: With stimulation at the wrist and recording over the ring finger, the median and ulnar DSL latency differences were recorded in 43 hands of 33 normals and 42 hands in 32 patients with mild CTS as defined by electrodiagnostic criteria. Standard DML from wrist to APB, and median DSL from wrist to index finger were also determined. They found that the median ulnar difference to the ring finger was more likely to be abnormal than the DML and DSL.
161. Vails J, Lianas JM: Orthodromic study of the sensory fibers innervating the fourth finger. Muscle Nerve 1988; 11:546-552. Criteria Met (3/6: 1,3,5) Source: Medline search.
162. White JC, Hansen SR, Johnson RK: A comparison of EMG procedures in the carpal tunnel syndrome with clinical-EMG correlations. Muscle Nerve 1988; 11:1177-1182. Criteria Met (4/6: 1,2,3,4) Source: Medline search. Abstract: Two hundred one hands in 122 patients were evaluated with several techniques for CTS. The asymptomatic hands of 43 of these patients served as controls. The following techniques were evaluated: (a) DML from wrist to APB, (b) DSL from wrist to index finger, (c) motor inching studies across the wrist to APB, (d) sensory inching studies across the wrist to the index finger. (e) inching studies to the lumbrical, (0 palm-to-wrist median latency, (g) comparison of median and radial DSLs, and (h) terminal latency index. Motor inching studies were most likely to be abnormal in both the CTS group and asymptomatic group. Motor inching studies were abnormal in 92% of mild CTS hands and 72% of the asymptomatic hands. All of the studies had high rates of abnormality in asymptomatic hands varying from 9% to 72%.
163. Wiederholt WC: Median nerve conduction velocity in sensory fibers through carpal tunnel. Arch Phys Med Rehabil 1970; 51:328-330. Criteria Met (5/6: 1,3,4,5,6) Source: Macleod, 1987. Abstract: With stimulation over the middle finger and recording distal and proximal to the carpal tunnel, sensory NCVs were determined across the carpal tunnel and proximal to the carpal tunnel in 30 normal adults. Sensory NCV was faster proximal to the carpal tunnel than across the carpal tunnel. No CTS patients were studied.
164. Wilbourn AJ, Lambert EH: The forearm median-to-ulnar nerve communication; electrodiagnostic aspects (abstract). Neurology 1976:26:368. Background Source Source: AAEM Consultant.
165. Wilbourn AJ: Electrodiagnosis of plexopathies. Aminoff MJ (ed). Neurologic Clinics: Symposium on Electrodiagnosis. Vol 3, Number 3:511-529. Philadelphia, W.B. Saunders, 1985, pp. 512-516. Criteria met: Background Source Source: AAEM Consultant.
166. Winn FJ Jr, Krieg EF Jr: A regression model for carpal tunnel syndrome. Proc Soc Exp Biol Med 1989; 192:161 -165. Criteria Met (2/6: 1,2) Source: Medline search.
167. Woltman HW: Neuritis associated with acromegaly. Arch Neural Psychiatry 1941; 45:680-682. Background Reference Source: Gelbermann, 1980.
168. Wongsam PE, Johnson EW, Weinerman, JD: Carpal tunnel syndrome: Use of palmar stimulation of sensory fibers. Arch Phys Med Rehabil 1983 Jan.:16-19 Criteria Met (4/6: 3,4,5,6) Source: Pease, 1989. Abstract: With stimulation at the wrist and midpalm and recording with ring electrodes over the middle finger, DSLs were obtained from the median nerve and 100 hands from 50 normal subjects, 15 patients with early CTS, and 6 with diabetes mellitus and superimposed median nerve entrapment. Amplitudes and durations of the SNAP were also reported. This technique is reported as useful in the diagnosis of CTS and underlying mild peripheral neuropathy.
169. Zachary RB: Thenar palsy due to compression of the median nerve in the carpal tunnel. Surg Gynecol Obstet 1945; 81:213217. Background Reference Source: Gelbermann, 1980.