CARPAL-TUNNEL-SYNDROME IN 100 PATIENTS - SENSITIVITY, SPECIFICITY OF MULTI-NEUROPHYSIOLOGICAL PROCEDURES AND ESTIMATION OF AXONAL LOSS OF MOTOR, SENSORY AND SYMPATHETIC MEDIAN NERVE-FIBERS
CARPAL-TUNNEL-SYNDROME IN 100 PATIENTS - SENSITIVITY, SPECIFICITY OF MULTI-NEUROPHYSIOLOGICAL PROCEDURES AND ESTIMATION OF AXONAL LOSS OF MOTOR, SENSORY AND SYMPATHETIC MEDIAN NERVE-FIBERS
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DOI：
10.1016/0022-510x(94)90076-0
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发表时间：
1994-12-20
影响因子：
4.4
通讯作者：
KUNTZER, T
中科院分区：
文献类型：
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作者：
KUNTZER, T
这项前瞻性研究符合AAEM质量保证委员会最近推荐的所有六项标准，并定义了100例临床怀疑患有腕管综合征（CTS）的患者和70例对照组的19项感觉运动和交感神经参数的异常、敏感性和特异性标准。9个参数达到了97%的特异性，允许在87%的研究患者的CTS的电诊断。这项研究的结果证实，正中感觉神经传导研究比运动神经传导研究更常见异常。评估了迄今为止未知的参数的有用性，如中值F波异常和剩余潜伏期、终末潜伏期指数和感觉神经动作电位（SNAP）振幅;这些参数的灵敏度不够，但特异性较高（SNAP振幅）或高灵敏度但低特异性（F波异常，剩余潜伏期和终末潜伏期指数），因此在CTS患者的早期临床电诊断评估中几乎没有价值。最后，在所研究的患者中，42%的病例中发现了一定程度的运动、感觉和交感正中神经纤维轴突丢失，6例患者患有双挤压综合征，另外6例伴有手肘尺神经病变。
This prospective study meets all six criteria recently recommended by a quality assurance committee of the AAEM and defines criteria of abnormality, sensitivity and specificity of 19 sensorimotor and sympathetic parameters in 100 patients who were suspected on clinical grounds of having carpal tunnel syndrome (CTS), and in 70 control subjects. Nine parameters reached a specificity of 97%, permitting the electrodiagnosis of CTS in 87% of the patients studied. The results in this study confirm that median sensory nerve conduction studies are more frequently abnormal than are studies of motor nerve conduction. The so far unknown usefulness of parameters such as median F-wave abnormalities and residual latency, terminal latency index and sensory nerve action potential (SNAP) amplitude was assessed; these parameters were not found sensitive enough, yet high specific (SNAP amplitude) or high sensitive yet low specific (F-wave abnormalities, residual latency and terminal latency index) and are therefore of little value in the early clinical electrodiagnostic evaluation of patients with CTS. Finally, in the patients studied, some degree of axonal loss for motor, sensory and sympathetic median nerve fibers was found in 42% of cases and 6 patients had a double-crush syndrome and 6 others had a concomitant ulnar neuropathy at the elbow.