Neurophysiological classification of carpal tunnel syndrome: Assessment of 600 symptomatic hands

L. Padua, M. Lo Monaco, R. Padua, B. Gregori, P. Tonali

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Following the AAEM electrodiagnostic guidelines, we developed a neurophysiological classification of carpal tunnel syndrome (CTS). Sixhundred hands with clinical CTS (mean age 51.4 yr., female/male ratio 5.5/7, right/left ratio 1.8/1) were prospectively evaluated and divided into six classes of severity only on the basis of median nerve electrodiagnostic findings: extreme CTS (EXT - absence of thenar motor responses), severe CTS (SEV - absence of sensory response and abnormal distal motor latency - DML), moderate CTS (MOD - abnormal digit-wrist conduction and abnormal DML), mild CTS (MILD - abnormal digit-wrist conduction and normal DML), minimal CTS (MIN exclusive abnormal segmental and/or comparative study), and negative CTS (NEC - normal findings at all tests) Using this neurophysiological classification, the CTS groups appeared normally distributed (EXT 3% of cases, SEV 14%, MOD 36%, MILD 24%, MIN 21%, NEC 3%), and the age of patients and clinical findings appeared to be related to neurophysiological abnormalities. Significant differences in median neurophysiological parameters not included in the classification (such as palm-wrist sensory conduction velocity) were observed in the different CTS groups. The analysis of the groups showed that: 1) the majority of advanced cases (SEV and EXT) occurred in older patients (60-80 years), 2) most of the milder cases (MIN and MILD) occurred in young female patients. The aim of this study was to standardise the neurophysiological evaluation of CTS.

Original languageEnglish
Pages (from-to)145-150
Number of pages6
JournalItalian Journal of Neurological Sciences
Issue number3
Publication statusPublished - 1997


  • Carpal tunnel syndrome
  • median nerve
  • neurophysiological classification

ASJC Scopus subject areas

  • Dermatology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Neuroscience(all)

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