Carpal tunnel syndrome (CTS) and cubital tunnel syndrome are very common nerve entrapments. Diagnosis is usually based on the clinical findings but the neurophysiological evaluation is now considered fundamental to confirm clinical diagnosis. The "Italian CTS Study Group" has performed a wide multicentric study on idiopathic carpal tunnel syndrome hands with a large and multi-prospective assessment. Overall, the sensitivity of "standard" neurophysiological tests (median digit-wrist sensory conduction velocity and wrist-thenar distal motor latency) was 83.5%. Comparative/segmental tests disclosed abnormal findings in a further 11.4% of cases, providing CTS electrodiagnosis in about 7 out of 10 "standard negative" cases. The overall sensitivity of the electrodiagnostic protocol used was 94.9%. Our data confirm the usefulness of a complete neurophysiological assessment by using segmental/comparative tests when standard tests yield normal results. With regard to the prognosis of untreated CTS, comparison of baseline and follow-up data showed a significant spontaneous improvement in patient-oriented and neurophysiologic measurements. A significant correlation between evolution and initial severity of CTS was observed: neurophysiologic and patient-oriented findings improved in the patients with more severe initial impairment while neu- rophysiologic and patient-oriented findings worsened in the patients with milder initial impairment. The main positive prognostic factor was the short duration of symptoms. Similarly, spontaneous improvement was more frequently associated with a young age. Conversely, baseline bilateral symptoms and positive Phalen test appeared to be negative prognostic factors. Cubital tunnel syndrome has not been studied as extensively as carpal tunnel syndrome. Recently, we developed a neurophysiologic classification and assessed the sensitivity of several neurophysiologic tests. We compared the neurophysiologic picture with the patient-oriented assessment.
|Issue number||4 SUPPL.|
|Publication status||Published - 2000|
ASJC Scopus subject areas
- Clinical Neurology