Ultrasonographic and Electrophysiological Evaluation of the Ulnar Nerve in Patients Diagnosed With Carpal Tunnel Syndrome

Ozlece, Hatice Kose; Huseyinoglu, Nergiz; Gök, Mustafa; İlik, Faik

doi:10.1097/wnp.0000000000000283

Cited by 10 publications

(12 citation statements)

References 23 publications

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“…Some studies have shown that patients with CTS may have UN damage [ 16 , 17 ]. A study by Kang et al found that when patients with CTS underwent carpal tunnel release, the pressure in Guyon’s canal was reduced and the sensory conduction of the UN improved [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…The greater incidence on the right side may be because most people are right-handed and perform more repetitive movements using the right hand than the left hand. Some studies have shown that patients with CTS may have UN damage [16,17]. A study by Kang et al found that when patients with CTS underwent carpal tunnel release, the pressure in Guyon's canal was reduced and the sensory conduction of the UN improved [16].…”

Section: Source Of the Curvementioning

confidence: 99%

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Ring finger sensory latency difference in the diagnosis and treatment of carpal tunnel syndrome

et al. 2021

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Objective To explore the sensitivity of median and ulnar nerve sensory latency differences in diagnosing carpal tunnel syndrome (CTS) at different severities. Methods CTS patients were divided into three groups based on disease severity (mild, moderate, and severe). Distal latency of sensory nerve action potential (SNAP) for the median and ulnar nerves was recorded. The sensitivity of SNAP distal latency to CTS and its correlation with CTS severity were analyzed. Results Significant differences were found in the median nerve sensory action potential distal latency (MSDL) and in the median and ulnar sensory latency difference to ring finger (MUD) but not in the ulnar nerve sensory action potential distal latency (USDL) between CTS and control. The sensitivity and specificity were 92.2 and 99.4% with an MSDL cutoff value of 2.40 ms, respectively, and were both 100% with a MUD cutoff value of 0.33 ms. There was no significant difference in USDL among the CTS and control groups. Significant differences were found in MSDL and MUD among the CTS severities and between mild and moderate CTS, but not between mild and severe CTS or between moderate and severe CTS. Correlations with CTS severity were observed for MSDL and MUD but not for USDL. Conclusion The ulnar nerve of the CTS patients was not damaged. A smaller MSDL reflected median nerve damage, which can be used for the early diagnosis of CTS. MUD correlated with CTS severity with a higher sensitivity than MSDL, which can provide therapeutic insight without pain to patients.

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Section: Discussionmentioning

confidence: 99%

Section: Source Of the Curvementioning

confidence: 99%

Ring finger sensory latency difference in the diagnosis and treatment of carpal tunnel syndrome

et al. 2021

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“…Some studies have shown that patients with CTS may have ulnar nerve damage (13,14). A study found that when patients with CTS underwent carpal tunnel release, the pressure in Guyon's canal is reduced and the sensory conduction of the ulnar nerve improves (13).…”

Section: Discussionmentioning

confidence: 99%

Ring Finger Sensory Latency Difference in the Diagnosis and Treatment of Carpal Tunnel Syndrome

Wang

Chu

Wang

et al. 2021

Preprint

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Objective: To explore the evaluation value of the sensitivity of the median/ulnar nerve sensory latency difference in the diagnosis of carpal tunnel syndrome and the evaluation value of severity.Methods: 122 patients with CTS and 42 normal controls were collected from the department of Neurology in Renmin Hospital of Wuhan University from July 2019 to January 2021. Electrophysiological tests were performed on the CTS patients group and the control group. The distal latency of the sensory nerve action potential (SNAP) of the median nerve and the ulnar nerve of the two groups was recorded. According to electrophysiological results，the patients were divided into three grades: mild, moderate and severe, the sensitivity of the nerve sensory action potential distal latency (SDL) to the diagnosis of CTS patients were analyzed, and the relationship with the severity of CTS was analyzed.Results: ①There were significant differences between the median nerve sensory action potential distal latency (MSDL) of 179 affected hands and the control group; And median and ulnar sensory latency difference to ring finger (MUD) was significantly different from the control group; But ulnar nerve sensory action potential distal latency （USDL） was not significantly different from the control group (P=0.182). When the cutoff value of MSDL is 2.465ms, the sensitivity is 85.5% and the specificity is 90.4%; when the cutoff value of MUD is 0.38ms, the sensitivity is 100% and the specificity is 100%. ②In the mild, moderate, severe and control group, there was no significant difference in USDL between all the groups (P=0.56)a; between the control group and the mild group, moderate group, and severe group, and between the mild and moderate, significant differences were found in the MSDL and MUD. No significant difference between mild and severe (P=0.66), moderate and severe (P=1.00). ③ MSDL and MUD are correlated with the severity of CTS. There is no correlation between USDL and CTS severity.Conclusion: The ulnar nerve is not damaged in CTS; a smaller MSDL can reflect median nerve damage, which is beneficial to the early diagnosis of CTS; MUD is more sensitive than MSDL in diagnosing CTS; MUD is correlated with severity, which is beneficial to pain for patients who are more sensitive and cannot tolerate electrical stimulation, perhaps only measuring MUD can reflect the severity, relieve the patient's pain, and can be used to evaluate the therapeutic effect.

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“…The CTS symptoms are mainly sensory in the region of median nerve innervation and median nerve abnormal SCS with or without motor abnormality associated with normal ipsilateral ulnar conduction. Numerous CTS patients had extra-median spread of Earlier electrophysiological studies have shown that traction of nearby ulnar nerve fibers may occur in patients with CTS [3,5,7,8,12,17]. In addition, in an old retrospective study involving the results of 234 cases with CTS, Sedal et al [3] reported that sensory nerve action potential amplitude of ulnar nerve was found to be abnormal in 39.3% of their CTS cases which was associated with increased sensory latency and reduced sensory amplitude of the ulnar nerve.…”

Section: Discussionmentioning

confidence: 99%

“…Guyon's canal (GC) syndrome is an uncommon peripheral neuropathy where the ulnar nerve is entrapped through the narrow canal at the wrist [2]. Many studies analyzed the possible ulnar nerve affection at the region of the wrist in CTS [1], which mainly involved sensory fibers, and that ulnar nerve conduction abnormality was augmented with the increase in the severity of CTS [3][4][5][6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of axonal loss in ulnar sensory nerve fibers recorded from ring and little fingers secondary to idiopathic carpal tunnel syndrome in Egyptian patients

El-Hady¹,

Molla²,

Ibrahim³

2020

Egypt Rheumatol Rehabil

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Background The association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment is unclear, and the extra-median paresthesia in the ulnar nerve territory innervation in CTS is unexplained. Our purpose is to evaluate the neurophysiologic changes in ulnar nerve sensory fibers secondary to idiopathic CTS in comparison to normal subjects, and their relation to the severity of CTS. Results The difference between CTS and control hands regarding all parameters of ulnar motor nerve conduction studies (MNCS) was not statistically significant (p > 0.05). There was a statistically significant difference in all parameters of median sensory conduction study (SCS) and MNCS between CTS and control hands (p < 0.0001) except for conduction velocity and in all parameters of median and ulnar SCS recording digit 4 (D4) (p < 0.05). The mean value of abnormalities of ulnar SCS recording D4 and digit 5 (D5) was significantly higher in moderate and severe CTS hands (p < 0.05). There were significant negative correlations between median motor and sensory latency and ulnar sensory amplitude recording D4 and D5. Conclusion Ulnar sensory nerve abnormalities exist among CTS patients, which were more in moderate and severe grades. The drop in amplitude of ulnar nerve sensory response argues in favor of the possible impact of CTS on the ulnar nerve and did not indicate axonal deterioration of the ulnar nerve.

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Ultrasonographic and Electrophysiological Evaluation of the Ulnar Nerve in Patients Diagnosed With Carpal Tunnel Syndrome

Abstract: Based on our study results, the ulnar nerve is affected electrophysiologically and morphologically in patients with CTS, especially those with advanced-stage CTS.

Cited by 10 publications

References 23 publications

Ring finger sensory latency difference in the diagnosis and treatment of carpal tunnel syndrome

Ring finger sensory latency difference in the diagnosis and treatment of carpal tunnel syndrome

Ring Finger Sensory Latency Difference in the Diagnosis and Treatment of Carpal Tunnel Syndrome

Evaluation of axonal loss in ulnar sensory nerve fibers recorded from ring and little fingers secondary to idiopathic carpal tunnel syndrome in Egyptian patients

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