Hand-held nerve conduction device in carpal tunnel syndrome: a prospective study.
ABSTRACT We assessed the clinical impact of replacing standard neurophysiologic testing with a hand-held device (Mediracer) for diagnosis of carpal tunnel syndrome (CTS).
One hundred patients (200 hands) with suspected CTS were studied by blinded assessors [Hand-therapist (HT)1 and Consultant Neurophysiologist] using the Mediracer, followed by standard neurophysiologic testing. To simulate testing by personnel without neurological training, Mediracer recordings were analyzed separately by an assessor who had not seen the patients (HT2).
Correlation of the CTS grades was 0.94 for the results obtained by HT1, and 0.87 for HT2. The sensitivity and specificity of the Mediracer was 0.85 and 0.9, respectively, by HT1, and 0.84 and 0.89 for HT2. Nine patients had conditions other than CTS, and 35 patients were judged to require further investigation.
The Mediracer should only be used in patients with typical CTS symptoms and signs and no muscle wasting who have had careful neurological assessment.
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ABSTRACT: The diagnostic utility and reliability of an easy-to-operate novel handheld nerve conduction tester in carpal tunnel syndrome (CTS) were evaluated. Using the test device, the sensory nerve conductions (SNC) in the median and ulnar nerves were compared with each other in 194 patients with suspected CTS and 95 healthy controls. The test device results were compared with the results of nerve conduction studies (NCS) with traditional instrumentation. The new device correctly classified 145 of the 149 hands (97.3%) without median nerve lesion and 171 of the 200 hands (85.5%) with median nerve lesions in traditional NCS. The specificity of the new tester compared with traditional instrumentation was 98%. The correlation coefficient for different technicians in different studies was 0.87. The findings obtained with the new tester in CTS were reliable and reproducible. This tester may increase availability of NCS in CTS.Acta Neurologica Scandinavica 07/2007; 115(6):390-7. · 2.47 Impact Factor
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ABSTRACT: Different ways of expressing the severity of carpal tunnel syndrome (CTS) are found in the existing literature and in clinical records. This paper documents the distribution of patients on a scale based upon the nerve conduction study findings, which are largely independent of the exact normal values used in any given laboratory and demonstrate a highly significant linear relationship between the neurophysiological grading and a numerical score derived from the clinical history. Patients with more characteristic stories of CTS generally have higher neurophysiological grades. The scale is as follows: normal (grade 0); very mild (grade 1), CTS demonstrable only with most sensitive tests; mild (grade 2), sensory nerve conduction velocity slow on finger/wrist measurement, normal terminal motor latency; moderate (grade 3), sensory potential preserved with motor slowing, distal motor latency to abductor pollicis brevis (APB) < 6.5 ms; severe (grade 4), sensory potentials absent but motor response preserved, distal motor latency to APB < 6. 5 ms; very severe (grade 5), terminal latency to APB > 6.5 ms; extremely severe (grade 6), sensory and motor potentials effectively unrecordable (surface motor potential from APB < 0.2 mV amplitude).Muscle & Nerve 09/2000; 23(8):1280-3. · 2.31 Impact Factor
- Acta Neurologica Scandinavica 12/2007; 118(3):203-5; author reply 206-7. · 2.47 Impact Factor