The electrodiagnosis of the carpal tunnel syndrome

Abstract

The carpal tunnel syndrome is one of the most commonly discussed subjects among the public, as well as the medical community, these days. Even though this is a rather simple nerve compression, which can be easily corrected, the carpal tunnel syndrome can induce further complications, sometimes leading to total disability of the patient. Early, proper diagnosis and treatment is very vital. Unfortunately, the exact pathomechanism and proper diagnosis is yet to be seen. As electromyographers, the authors would like to re-visit this debatable carpal tunnel syndrome emphasizing the electrodiagnosis. Among the electrodiagnostic tests, comparison of distal motor or sensory latency of the median nerve to the ulnar nerve along with amplitude of the response, was found to be the most sensitive test. Also, the C6 cervical radiculopathy and the pronator syndrome can present similar clinical pictures and require a differentiation. After successful surgery many patients still complain of subjective residual symptoms. The electrophysiologic findings do not correspond to the clinical progress in many cases. The authors also experienced that most of the victims, following successful surgery, still would benefit from a proper exercise program including instruction for proper body mechanics before they return to their previous activities, to lessen the undesirable complications including the reflex sympathetic dystrophy.