Orthodromic median and ulnar fourth digit sensory conductions in mild carpal tunnel syndrome

Uncini, Antonino; Muzio, Antonio Di; Cutarella, Rocco; Awad, J.; Gambi, D.

doi:10.1016/s0987-7053(05)80169-8

Cited by 10 publications

(9 citation statements)

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“…Comparison studies are most useful with mild disease or underlying polyneuropathy, and the sensitivity values of these studies are higher (82% and 77%) than those for standard conduction studies. 30,43,[55][56] The use of multiple potentially more sensitive tests (ie, comparison studies) deserves a note of caution, as these tests will decrease the number of false negatives, but also potentially may increase the number of false positives. 43,51 Redmond and Rivner 51 state that electrophysiologic procedures have, however, become so sensitive that they cannot only confirm the clinical diagnosis of carpal tunnel syndrome in most patients but also detect an incidental finding in some asymptomatic subjects.…”

Section: Discussionmentioning

confidence: 99%

Median and Ulnar Neuropathies in University Guitarists

Kennedy¹,

Hutcherson²,

Kain³

et al. 2006

J Orthop Sports Phys Ther

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Study Design: Descriptive study. Objectives: To determine the presence of median and ulnar neuropathies in both upper extremities of university guitarists. Background: Peripheral nerve entrapment syndromes of the upper extremities are well documented in musicians. Guitarists and plucked-string musicians are at risk for entrapment neuropathies in the upper extremities and are prone to mild neurologic deficits. Methods and Measures: Twenty-four volunteer male and female guitarists (age range, 18-26 years) were recruited from the Belmont University School of Music and the Vanderbilt University Blair School of Music. Individuals were excluded if they were pregnant or had a history of recent upper extremity or neck injury. Subjects completed a history form, were interviewed, and underwent a physical examination. Nerve conduction status of the median and ulnar nerves of both upper extremities was obtained by performing motor, sensory, and F-wave (central) nerve conduction studies. Descriptive statistics of the nerve conduction study variables were computed using Microsoft Excel. Results: Six subjects had positive findings on provocative testing of the median and ulnar nerves. Otherwise, these guitarists had normal upper extremity neural and musculoskeletal function based on the history and physical examinations. When comparing the subjects' nerve conduction study values with a chart of normal nerve conduction studies values, 2 subjects had prolonged distal motor latencies (DMLs) of the left median nerve of 4.3 and 4.7 milliseconds (normal, Ͻ 4.2 milliseconds). Prolonged DMLs are compatible with median neuropathy at or distal to the wrist. Otherwise, all electrophysiological variables were within normal limits for motor, sensory, and F-wave (central) values. However, comparison studies of median and ulnar motor latencies in the same hand demonstrated prolonged differences of greater than 1.0 milliseconds that affected the median nerve in 2 additional subjects, and identified contralateral limb involvement in a subject with a prolonged distal latency. The other 20 subjects demonstrated normal comparison studies of the median and ulnar nerves in both upper extremities. David G. Greathouse, 3211 Crystal Path, San Antonio, Conclusions: In this descriptive study of a population of 24 university guitarists, 4 musicians (17%) were found to have electrophysiologic evidence of median neuropathy at or distal to the wrist or carpal tunnel syndrome. Ulnar nerve electrophysiological function was within normal limits for all subjects examined.

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Section: Discussionmentioning

confidence: 99%

Median and Ulnar Neuropathies in University Guitarists

Kennedy¹,

Hutcherson²,

Kain³

et al. 2006

J Orthop Sports Phys Ther

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“…One of the key tests for the determination of a focal lesion in the median nerve is the comparison with another nerve (i.e., the radial or the ulnar) using either the same recording or the same stimulation site. This has been done by various authors using either antidromic or orthodromic techniques, with the fourth finger for the comparison to ulnar nerve and the thumb for comparison to radial nerve action potentials (Loong and Seah, 1971, Johnson et al, 1981, Johnson et al, 1987, Carroll, 1987, Pease et al, 1989, Uncini et al, 1990). This method has been found to have 90% sensitivity in differentiating nerve compression from polyneuropathy in diabetic patients (Imada et al, 2007, Gazioglu et al, 2011).…”

Section: Antidromic and Orthodromic Testing Of Carpal Tunnel Syndromementioning

confidence: 99%

Antidromic vs orthodromic sensory median nerve conduction studies

Valls‐Solé

Leote

Pereira

2016

Clinical Neurophysiology Practice

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“…Thirteen published studies were evaluated and met criteria for review compared with a reference standard of signs, symptoms, and one electrodiagnostic test. Twelve of these studies [15][16][17][18][19][20][21][22][23][24][25][26] were level IV and one 27 was level II. The reference standard used included signs, symptoms, and a different electrodiagnostic test than the electrodiagnostic test being evaluated in the study.…”

Section: Recommendation 3: Nerve Conduction Velocity Studiesmentioning

confidence: 99%