Neurophysiological Findings in Patients with Carpal Tunnel Syndrome by Nerve Conduction Study in Comparing with Ultrasound study

Abstract

Carpal Tunnel Syndrome (CTS) is the most common entrapment problem of upper limb compressive neuropathy. Clinically, the patient presented with pain and parasthesia in median nerve distribution sites and sometimes all the hand and even the pain may affect the forearm and arm, in severe cases thenar muscles atrophy.  The signs and symptoms occur due to compression of median nerve at wrist as a result of increase the carpal tunnel pressure by any condition that can increase the pressure within tunnel.

The aim of the study is to assess the correlation of CTS severity by nerve conduction study and it's correlation with US results and their relation with other risk factor such as duration of disease and body mass index.

The study was conducted in Merjan Medical City, in the period from January 2013 to December 2014. And included 94 patients group (164 hands) with signs and symptoms of CTS as well as positive NCS with age ranged from 20-70 years. The study also includes control group 64 persons (128 hands) which were matched age, gender and BMI as patients group.

Results: there were significant differences in NCS of median nerve both sensory and motor parameters between patients and control groups. The patients group divided according to NCS as 73 (45%) had mild, 63(38%) had moderate, and 28(17%) had severe CTS. There were significant difference among group severity of disease and increase BMI. There was a high significant difference in the duration of disease and disease severity. There was significant relationship between dominant hands and disease severity. There is significant correlation between age and severity of disease determined by NCS. There was significant relationship between onset of symptom (day and night and night alone) and the severity of CTS by NCS, in mild CTS 75.0% night symptoms, while in severe CTS 71.4% day and night symptoms.

Keywords: Carpal Tunnel syndrome, Severity, NCS and US .