Comparison of median and ulnar sensory nerve action potentials in the diagnosis of the carpal tunnel syndrome

Loong, Susan; Seah, C. S.

doi:10.1136/jnnp.34.6.750

Cited by 53 publications

(12 citation statements)

References 8 publications

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“…Motor conduction velocities in the ulnar nerve were not determined on all our patients, but in over half the patients with abnormal ulnar nerve sensory action potentials on whom motor conduction studies were carried out the lesion was found to be at the elbow. Loong and Seah (1971) have suggested that measurement of the ratio of median to ulnar nerve sensory action potential amplitude may be valuable in the diagnosis of carpal tunnel syndrome. Although an associated ulnar nerve lesion would not alter the validity of such a test, it may be expected to reduce its sensitivity.…”

Section: Carpal Tunnel Syndrome With Reduced Median Nerve Motor Condumentioning

confidence: 99%

Ulnar nerve lesions associated with the carpal tunnel syndrome

Sedal

McLeod

Walsh

1973

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY Electrophysiological studies were performed on median and ulnar nerves in 234 cases of carpal tunnel syndrome. Abnormalities of the ulnar nerve sensory action potential were found in 39.3%0 of cases. The amplitude of the ulnar nerve sensory action potential was related to the amplitude of the median nerve sensory action potential, and to the median nerve motor conduction velocity in the forearm. The findings suggest that in a significant proportion of patients with carpal tunnel syndrome, a more generalized subclinical neuropathy may be present.The association of ulnar nerve abnormalities with carpal tunnel syndrome has received little attention. In performing routine diagnostic nerve conduction studies in patients with the syndrome, an appreciable incidence of such abnormalities was noted. This stimulated a review of all patients with carpal tunnel syndrome studied over the past five years with particular emphasis on the frequency of ulnar nerve abnormalities and their significance in the pathogenesis of the syndrome. METHODS SUBJECTS There were 234 cases of carpal tunnel syndrome in the series. These comprised 214 patients, 20 of whom had bilateral abnormalities; 119 of the patients were women and 95 were men. Their ages ranged from 19 to 87 (mean, 54) years. Thirty-four control subjects were also studied in whom there was no history or physical sign of neurological disease nor of systemic disorders known to predispose to neuropathy. Their ages ranged from 18 to 77 (mean, 47) years.The criteria used for the diagnosis of carpal tunnel syndrome were a history or physical signs of carpal tunnel syndrome together with one or more of the following three electrophysiological abnormalities (Gilliatt and Sears, 1958): (1) a median motor latency at the wrist greater than 5 0 msec; (2) a median sensory latency at the wrist greater than

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Section: Carpal Tunnel Syndrome With Reduced Median Nerve Motor Condumentioning

confidence: 99%

Ulnar nerve lesions associated with the carpal tunnel syndrome

Sedal

McLeod

Walsh

1973

Journal of Neurology, Neurosurgery & Psychiatry

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“…However, no study has been done up to this writing on CTS in paraplegic patients. We decided to study the ulnar nerve as well for comparison (Loong, 1971;Strephaniwsky, Bilowitt and Prasad, 1980).…”

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confidence: 99%

Carpal tunnel syndrome in paraplegic patients

et al. 1985

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SutntnaryMedian nerve compression at the wrist (Carpal Tunnel Syndrome) is commonly associated with local trauma around the flexor retinaculum. Repeated manual activity also exacerbates the disease severity . We undertook a prospective study of the incidence of Carpal Tunnel Syndrome (CTS) in 47 paraplegic patients who have used their hands extensively for daily activity. Since surgical decompression generally provides excellent relief of symptoms, early detection of CTS will be particularly important in these patients. Of the 47 patients studied, 19 had clinical CTS (40%). A total of 91 hands (nerves) were tested with motor and sensory nerve conduction of the median and ulnar nerves. Electrophysiological evidence of CTS was noted in 57 hands (63%). The incidence of CTS appears to be related to the duration of Spinal Cord Injury. Concurrent ulnar neuropathy at the elbow was noted in 19 patients (40%). There was no predisposing factor such as diabetes mellitus in any of these patients, and the compressive neuropathy appears to be purely mechanical.

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“…In view of the unusually large scatter of motor and sensory latency in normal median nerve (Hongell and Mattsson, 1971) we are presenting data on motor and sensory conduction 340 in a large group of normal subjects under standardized conditions. We have evaluated whether findings in median compared with those in ulnar nerve in the same patient allow mild or borderline cases of entrapment at the wrist to be recognized (Loong and Seah, 1971). 2.…”

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confidence: 99%

Electrophysiological findings in entrapment of the median nerve at wrist and elbow

Buchthal

Rosenfalck

Trojaborg

1974

Journal of Neurology, Neurosurgery & Psychiatry

264

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SYNOPSISIn 117 consecutive patients with carpal tunnel syndrome and 11 patients with a compression syndrome of the median nerve at elbow, motor and sensory conduction along the median and ulnar nerves and quantitative electromyography were compared with findings in 190 normal controls of the same age. In 25% of patients with carpal tunnel syndrome in whom motor conduction and EMG were normal, the lesion was located from abnormalities in sensory conduction. The fact that conduction along the same fibres was moderately slowed from digit to palm, severely slowed across the flexor retinaculum, and normal from wrist to elbow indicates that slowing was due to demyelination at the site of compression. Fifteen per cent of the patients with carpal tunnel syndrome had clinical and electrophysiological signs of ulnar involvement. In the other patients conduction along the ulnar nerve was as in 100 normal controls. Compression at the elbow was located by electromyographical findings rather than by abnormalities in conduction.

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Comparison of median and ulnar sensory nerve action potentials in the diagnosis of the carpal tunnel syndrome

Cited by 53 publications

References 8 publications

Ulnar nerve lesions associated with the carpal tunnel syndrome

Ulnar nerve lesions associated with the carpal tunnel syndrome

Carpal tunnel syndrome in paraplegic patients

Electrophysiological findings in entrapment of the median nerve at wrist and elbow

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