Distribution of paresthesias in Carpal Tunnel Syndrome reflects the degree of nerve damage at wrist
Distribution of paresthesias in Carpal Tunnel Syndrome reflects the degree of nerve damage at wrist
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DOI：
10.1016/j.clinph.2005.09.001
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发表时间：
2006-01-01
影响因子：
4.7
通讯作者：
Padua, L
中科院分区：
文献类型：
--
作者：
Caliandro, P;La Torre, G;Padua, L
目的：为了验证是否分布在腕管综合征（CTS）患者的感觉异常的神经生理involvement.Methods的程度有关：我们进行了一项横断面研究，并回顾性评价了163例患者谁提到我们的肌电图实验室和CTS的临床和电生理诊断。我们将患者分为两组：（1）主诉手部整体感觉异常的患者和（2）正中神经区域感觉异常的患者。我们将手部感觉异常的分布称为手套，将正中神经的分布称为正中神经。我们比较了GLOVE和MEDIAN分布的神经生理学损害。此外，我们进行了多元回归分析，以评估哪些临床神经生理变量决定GLOVE和MEDIAN distribution.Results：在我们的样本中，70.4%的患者有GLOVE分布和29.6%的患者MEDIAN分布。呈现中位数分布的风险增加约两倍（OR= 2.07; 95%IC：1.51-2.83）结论：感觉异常的分布反映了腕部神经损伤的程度，SEV/EXT CTS患者呈MEDIAN分布，其意义：我们的数据具有重要的临床意义，因为它们强烈提示我们必须考虑在主诉MEDIAN分布的患者中腕部正中神经严重神经生理学受累的可能性。(c)2005年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To verify whether the distribution of paresthesias in patients with Carpal Tunnel Syndrome (CTS) is related to the degree of the neurophysiological involvement.Methods: We performed a cross-sectional study and retrospectively evaluated 163 patients who referred to our electromyography lab and to which a clinical and electrophysiological diagnosis of CTS was made. We divided the patients into two groups: (1) patients complaining of paresthesias at the hand as a whole and (2) patients with paresthesias in the territory of the median nerve. We referred to the distribution of paresthesias at the hand as GLOVE and to the distribution in the territory of the median nerve as MEDIAN. We compared the neurophysiological impairment in GLOVE and MEDIAN distributions. Moreover, we performed multiple regression analysis to evaluate which clinical-neurophysiological variables determined GLOVE and MEDIAN distribution.Results: In our sample, 70.4% of patients had GLOVE distribution and 29.6% of patients MEDIAN distribution. The risk of presenting MEDIAN distribution increases about twice (OR= 2.07; 95% IC: 1.51-2.83) for each unitary increment of neurophysiological class.Conclusions: The distribution of paresthesias reflects the degree of nerve damage at wrist; patients suffering of SEV/EXT CTS present MEDIAN distribution.Significance: Our data have important clinical implications because they strongly suggest that we have to consider the possibility of a severe neurophysiologicat involvement of the median nerve at wrist in patients complaining of MEDIAN distribution. (c) 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.