Mar 12, 2015 - ABSTRACT. Introduction: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by compression of median.
International Journal of Therapies and Rehabilitation Research [E-ISSN: 2278-0343] http://www.scopemed.org/?jid=12
IJTRR 2015, 4: 3 I doi: 10.5455/ijtrr.00000054
Original Article
Open Access
Relationship of electrodiagnostic findings with severity of symptoms and function in subjects with carpal tunnel syndrome Noopur G Bhatt1, Dr. Megha S Sheth2, Dr. Neeta J Vyas3
ARTICLE INFO
ABSTRACT
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Introduction: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by compression of median nerve beneath transverse carpal ligament resulting in mechanical compression and/or local ischemia. Diagnosis of CTS involves combination of clinical symptoms, accurate examination and nerve conduction studies. Objective: The aim of the study was to correlate electrodiagnostic findings with patient symptom severity and function. Method: Patient symptom severity and functional limitations were assessed in 30 subjects, both males and females, diagnosed as having CTS based on clinical findings of one or more of the symptoms in median nerve distribution such as tingling, numbness, pain, weakness and positive Phalen’s test. Exclusion criteria were patients with existing neurological conditions such as polyneuropathy, cervical radiculopathy or rheumatic disease. Outcome measures included Carpal Tunnel Syndrome Questionnaire (CTSQ) which has two sub scales; symptom severity scale and functional status scale and Nerve Conduction Studies (NCS). NCS were performed for all. Level of significance was kept at 5%. Results: Spearman correlation test was used. A statistically significant correlation was found between Distal Motor Latency (DML), Distal Sensory Latency (DSL) and Sensory Nerve Action Potential amplitude (SNAP) with symptom severity scale (r=0.437, p=0.008; r=0.418, p=0.011; r=-0.590, p3.4 ms; Median nerve distal motor latency over the thenar >4.4 ms; Difference between median and ulnar nerve distal sensory latencies >0.2 ms; Difference between the distal motor latency of median & ulnar nerve > 1.1ms;
RESULTS
Table-2 Mean and SD values of Electrodiagnostic findings and scale scores Variables
Mean
+Standard deviation (SD)
DML (msec)
5.57
1.78
DSL(msec)
4.42
2.58
CMAP(millivolts)
9.77
5.87
SNAP(microvolt)
12.67
11.21
SYMPTOM SEVERITY SCALE
2.97
0.75
FUNCTIONAL STATUS SCALE
2.84
0.89
Table-4 Correlation values of electrodiagnostic findings with functional status scale Variables
Statistical analysis was done using Statistical Package for Social Sciences (SPSS) VERSION 16. There were 26 females and 4 males. Mean age of the participants was 46.6+10.32 Years. As the data was not following the normal distribution, Spearman correlation coefficient test was used to identify the relationship of electrodiagnostic findings with patient symptom severity and function. A statistically significant moderate positive correlation was found between DML and DSL with symptom severity scale and functional status scale whereas moderate negative correlation was found between SNAP amplitude with symptom severity scale and with functional status scale. Table 1 Normal values of Latencies & Amplitude of Median 10 nerve at wrist Electrodiagnostic variables
Values
DML(ms)
3.49+0.34
DSL(ms)
3.06+0.41
CMAP(mille volts)
7.0+3.0
SNAP(micro volts)
8.91+4.48
Table-3 Correlation values of electrodiagnostic findings with symptom severity scale Variables DML
