To determine the diagnostic utility of waveform analysis of compound muscle action potentials (CMAP) for carpal tunnel syndrome (CTS).
Methods.
A total of 131 hands in 71 patients diagnosed with CTS (grouped according to severity) and 80 hands in 44 normal subjects were evaluated using nerve conduction test through the carpal tunnel combined with waveform analysis of CMAP.
Results.
Compared to normal subjects, the sensory nerve conduction velocity and mean frequency of the CMAP waveform were significantly reduced in patients with CTS. Compared with distal motor latency and sensory nerve conduction velocity, the mean frequency of the CMAP decreased significantly with increasing clinical severity.
Conclusion.
This study suggests that waveform analysis of CMAP is of diagnostic value in CTS, and is also of value in objective evaluation of postoperative recovery of carpal median nerve dysfunction.
SatoK. Clinical view and diagnosis of carpal tunnel syndrome. MB Orthop1995;8:1–6.
2.
ShivdeAJDreizinIFisherMA. The carpal tunnel syndrome. A clinical-electrodiagnostic analysis. Electromyogr Clin Neurophysiol1981;21:143–53.
3.
MacKinnonSEDellonAL. Carpal tunnel syndrome. In: MacKinnonSEDellonAL, editors. Surgery of the peripheral nerve. 1st ed.New York: Thieme Medical Publisher; 1988:146–69.
4.
KimuraJ. The carpal tunnel syndrome: Localization of conduction abnormalities within the distal segment of the median nerve. Brain1979;102:619–35.
5.
NakanishiTTamakiMMizusawaHAkatsukaTKinoshitaT. An experimental study for analyzing nerve conduction velocity. Electroencephalogr Clin Neurophysiol1986;63:484–7.
6.
PrestonDCLogigianEL. Lumbrical and interossei recording in carpal tunnel syndrome. Muscle Nerve1992;15:1253–7.
7.
UnciniADi MuzioAAwadJManenteGTafuroMGambiD. Sensitivity of three median-to-ulnar comparative tests in diagnosis of mild carpal tunnel syndrome. Muscle Nerve1993;16:1366–73.
8.
PrestonDCRossMHKothariMJPlotkinGMVenkateshSLogigianEL. The median-ulnar latency difference studies are comparable in mild carpal tunnel syndrome. Muscle Nerve1994;17:1469–71.
9.
NaitoYKuzuharaS. Application of the collision method for median nerve conduction study in carpal tunnel syndrome. Jpn J EEG EMG1995;23:408–13.
10.
SheeanGLHouserMKMurrayNM. Lumbrical-interosseous latency comparison in the diagnosis of carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol1995;97:285–9.
11.
PaduaLLo MonacoMValenteEMTonaliPA. A useful electrophysiologic parameter for diagnosis of carpal tunnel syndrome. Muscle Nerve1996;19:48–53.
12.
SerorP. The axonal carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol1996;101:197–200.
13.
KimuraJ. Electrodiagnosis in diseases of nerve and muscle: Principles and practice. Philadelphia: FA Davis Co; 1989.
14.
HoffmannP. Uber eine Methode, den Erfolg einer Nervennaht zu beurteilen. Klinik1915;13:359–60.
15.
TinelPJ. Le signe du ‘Fourmillement’ dans les lesions des nerfs peripheriques. Presse. Medicale1915;47:388–9.
16.
HirasawaY. Conservative therapy of peripheral nerve injury. Book of Orthopaedics1983;1-A:238–48.
17.
KatsumiYHirasawaY. Planning of physical and laboratory examination peripheral neuropathy. Orthop Surg Traumatol1984;27:1565–72.
18.
HirasawaY. Peripheral nerve disorder in forearm. J Clin Med1988;5:409–17.
19.
MatsumotoJ. Frequency analysis of surface electromyogram during static of skeletal muscle. Kitakanto Med J1967;17:369–87.
20.
SameshimaM. Frequency analytical data processing of surface and its clinical application. Kitakanto Med J1971;21:292–319.
21.
HashimotoTAsadaKYoshidaKKitamuraYShimanakaA. Evaluation of muscle function with using of integrated EMG and power spectrum. Cent Jpn J Orthop Traumat1986;29:1722–4.
22.
TakayanagiKIharaHNakayamaAYoshimuraSShimobatakeH. Characteristics of eccentric and concentric muscular contraction on knee flexors and extensors -examination with power spectrum of surface EMG-. Phys Ther1990;17:3–10.
23.
YoshidaG. Evaluation of muscle function in knee extension and flexion using isokinetic machine and surface EMG. Cent Jpn J Orthop Traumat1996;39:1175–88.
24.
IinoMHasegawaOMatsumotoSKuritaT. Stimulation threshold of motor and sensory nerves: An analysis using microneurography. Clin Electroencephalogr1997;39:394–6.
OguraTOsawaTHirasawaY. The relationship between the parameter of nerve conduction study and clinical grade in carpal tunnel syndrome. Clin Electroencephalogr1997;39:364–7.
27.
PaduaLLo MonacoMGregoriBValenteEMPaduaRTonaliP. Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand1997;96:211–7.
28.
AulisaLTamburrelliFPaduaRRomaniniELo MonacoMPaduaL. Carpal tunnel syndrome: Indication for surgical treatment based on electrophysiologic study. J Hand Surg [Am]1998;23:687–91.
