Time course and predictors of median nerve conduction after carpal tunnel release

Clinical Outcomes of Electrodiagnostic Testing Conducted in Primary Care

“…36 For example, if a patient has a pretest probability of carpal tunnel syndrome of .5 based on their clinical examination, then a positive study raises the probability to Ͼ.90 because computerized EDX testing has been shown to have a positive likelihood ratio of Ͼ10 for detecting median neuropathy at the wrist. 15,16 In approximately 60% of tests, computerized EDX testing confirmed the physician's pretest diagnosis. Physicians attribute significant value to diagnostic results that reassure them that they've made a correct diagnosis.…”

“…13,14 Further, because of inherent consistency, the accuracy of the results as assessed in controlled clinical studies should translate to clinical practice. Diagnostic accuracy, with traditional EDX instrumentation or neuroimaging (for radiculopathy) as reference standards, has been reported for carpal tunnel syndrome, [15][16][17] upper-extremity nerve function in symptomatic patients, 18 -20 diabetic peripheral neuropathy, 21,22 lumbosacral radiculopathy, [23][24][25][26] and lower-extremity nerve function in symptomatic patients. 27 Computerized EDX studies are now commonly provided by primary care physicians.…”

Utility of Nerve Conduction Studies for Carpal Tunnel Syndrome by Family Medicine, Primary Care, and Internal Medicine Physicians

“…15,17,19 -21 These coefficients are comparable to inter-examiner correlation between board certified electromyographers. 22 In 3 studies meeting class I or II evidence-based critieria, 15,17,21 the positive and negative likelihood ratios for CTS ranged from 8.6 to Ͼ10 and 4.3 to 8.6, respectively (likelihood ratios calculated from reported sensitivity, specificity, and raw agreement). These likelihood ratios represent clinically meaningful changes from pretest to post-test disease probability in terms of both ruling-in and rulingout CTS.…”

“…Instrument operation and accuracy in detecting CTS have been described. 7,15,17 In brief, this instrument performs conventional motor and sensory NCS. It automates the technical steps of a NCS including electrode placement, skin surface temperature correction, determination of nerve stimulation intensity, and analysis of the evoked neuroelectrical responses.…”

Electrophysiological and functional outcome after carpal tunnel release in patients with carpal tunnel syndrome: A prospective evaluation

“…Gold standard for diagnosis is the combination of the clinical findings and the electrophysiological study [6,7] Diagnostic criteria for CTS in nerve conduction studies (NCS) include the median nerve showing extended amounts of sensory and motor latencies as well as diminished sensory and motor conduction velocities [1] . The sensitivity and specificity of a nerve conduction monitoring system help in detecting and aiding in the diagnosis of CTS and is useful in the long-term management of patients with CTS by aiding in determining the level of improvement in median nerve function after carpal tunnel release (CTR) [8] .…”