The Role of Electrodiagnostic Studies in Carpal Tunnel Syndrome: Beyond Confirmation of Diagnosis

Babaei-Ghazani, Arash; Roomizadeh, Peyman

doi:10.3928/01477447-20180227-01

Cited by 2 publications

(2 citation statements)

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“…Nevertheless, many controversies have arisen regarding the necessity of NCSs as confirmatory tests or tools contributing to patient management [ 19 , 20 , 21 , 22 ]. These controversies emanate mainly by the rise of the time and the cost needed for the diagnosis of CTS with the use of NCSs [ 23 , 24 ], the discomfort caused to the patients by nerve stimulation, and the high rate of false positive and false negative results of NCSs along with the ease and the accuracy of clinical diagnosis in many cases with symptoms and signs typical of CTS [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

et al. 2021

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Recent literature has revealed a long discussion about the importance and necessity of nerve conduction studies in carpal tunnel syndrome management. The purpose of this study was to investigate the possibility of automatic detection, based on electrodiagnostic features, for the median nerve mononeuropathy and decision making about carpal tunnel syndrome. The study included 38 volunteers, examined prospectively. The purpose was to investigate the possibility of automatically detecting the median nerve mononeuropathy based on common electrodiagnostic criteria, used in everyday clinical practice, as well as new features selected based on physiology and mathematics. Machine learning techniques were used to combine the examined characteristics for a stable and accurate diagnosis. Automatic electrodiagnosis reached an accuracy of 95% compared to the standard neurophysiological diagnosis of the physicians with nerve conduction studies and 89% compared to the clinical diagnosis. The results show that the automatic detection of carpal tunnel syndrome is possible and can be employed in decision making, excluding human error. It is also shown that the novel features investigated can be used for the detection of the syndrome, complementary to the commonly used ones, increasing the accuracy of the method.

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Section: Introductionmentioning

confidence: 99%

Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

et al. 2021

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“…Так за нашими даними 66 % хворих з клінічними симптомами КТС, які були направлені або самостійно звернулися до нашого закладу з невстановленим діагнозом, на попередніх етапах отримували лікування остеохондрозу шийного відділу хребта, а 34% -іншої ортопедичної патології в області кистьового суглобу [3]. Для диференційної діагностики з іншою патологією та верифікації діагнозу ІКН СН в КК, визначення ступеню тяжкості ураження СН широко використовують інструментальні методи дослідження, серед яких найбільш поширеним та інформативним до цього часу залишається електроміографія (ЕМГ) з дослідженням нервової провідності (nerve conduction study, NCS) [4][5][6][7][8]. Саме цей метод дозволяє локалізувати місце ураження та визначити ступінь тяжкості ураження різних структур нервового стовбура.…”

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Diagnostic Relevance of Electromyographic Values and their Role in Forecasting the Conservative Treatment in Patients with Carpal Tunnel Syndrome

Haiko,

Klymchuk

2023

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Summary. Instrumental investigation and electromyography (EMG), one of the most widespread and informative of its methods, still remains widely used for differentiated diagnostics with any other disorder, compressive-ishemic focal neuropathy (CIFN) of the median nerve (MN) ) at the level of the carpal tunnel (CT) diagnosis verification and determination of the severity of damage to the MN. The clinical diagnosis of this pathologyis better know as carpal tunnel syndrome (CTS). Objective: To study the diagnostic relevance of electromyographic values in the Ukrainian population of CTS patients and their role in forecasting the efficiency of conservative treatment of this disorder. Materials and methods: 128 patients (204 extremities) with the clinical signs of CTS, who formed the Main Group (MG) underwent electromyography (EMG). The mean age of the patients was 58.2±12.5 years old; among them were 105 (82 %) women and 23 (18 %) men; 77 persons with a bilateral and 51 with a unilateral process. The control group (CG) included 30 volunteers (54 extremities) without any claims and signs of neurological symptoms. The mean age was 45.1±7.8 years old; among them were 23 (77.6%) women and 7 (23,3%) men. To determine the EMG predictors of the effectiveness of clinical outcomes after paraneural corticosteroid injection (PCI) 58 extremities MG were examined.For the EMG examination, we used the «Viking Quest» machine by Nicollet, the USA. Applying relevant methods, we investigated the following: median motor distal latency (DMLm) and CMAP of M. abductor pollicis brevis (APB); median sensory distal onset (MOL-D2), median sensory distal peak latency (MPL-D2), median SNAP amplitude digit 2, median sensory conduction velocity between wrist and digit 2 (mSNCV); difference in median sensory onset latency (digit 1) (MSL-D1) to radial sensory onset latency (digit 1) (RSL-D1) – MD1-RD1; difference in median nerve distal motor latency (2nd lumbrical)to the ulnar nerve distal motor latency (2nd interossei) – 2LI-DML; interrelation of the amplitudes of CMAP APB obtained by the stimulation of the MN on the level of the lower third of forearm to the amplitude of CMAP APB – on the level of the lower third of a palm (wrist to palm amplitude ratio); the sensory ulnar nerve conduction velocity (uSNCV). Results: The analysis of mean values of the core EMG values has demonstrated the significant differences between MG and CG, with different directions of changes, typical of the CTS. Relying on the data collected while studying people from the CG (the discovered referential and abnormal values) and the ROC analysis, we have established the sensitivity and specificity of EMG values: DMLm – 73.5% and 96.3%; MPL-D2 – 81.9% and 100%; mSNCV– 93.9% and 100%; MD1-RD1 – 62.5% and 100%; MSL-D1– 83.3% and 96.9%; 2LI-DML – 88.2% and 100%, respectively (AUC=0,91-0.96). Based on the results of the ROC analysis, determined that the most prognostically significant EMG predictor of clinical outcome after PCI was median SNAP amplitude digit 2 (sensitivity 90,9% and specificity 92%, AUC=0,95. Conclusions: The EMG is the objective and informative method to diagnose CIFN of the MN at the level of the CT, severity of nerve damage in CTS patients and predicting of clinical outcome after PCI.

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The Role of Electrodiagnostic Studies in Carpal Tunnel Syndrome: Beyond Confirmation of Diagnosis

Cited by 2 publications

References 5 publications

Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

Automatic Electrodiagnosis of Carpal Tunnel Syndrome Using Machine Learning

Diagnostic Relevance of Electromyographic Values and their Role in Forecasting the Conservative Treatment in Patients with Carpal Tunnel Syndrome

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