Imai Tomihiro, Wada Takuro, Matsumoto Hiroyuki
Department of Neurology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan.
Clin Neurophysiol. 2004 Nov;115(11):2514-7. doi: 10.1016/j.clinph.2004.05.015.
The aim of this study is to elucidate the significance of electrophysiological data of the palmar cutaneous branch of the median nerve (PCBm) in the diagnosis entrapment of the PCBm concomitant with carpal tunnel syndrome (CTS).
Clinical and electrophysiological studies were conducted for abnormal sensation of the thenar eminence in eight CTS patients. Sensory nerve action potentials (SNAPs) of the PCBm were recorded from bipolar surface electrodes over the forearm using an orthodromic method. The preoperative SNAP evaluation was compared with the operative findings.
The eight patients were divided into two groups based on the characteristics of SNAPs of the PCBm; five patients had normal SNAPs of the PCBm and three patients had delayed or absent SNAPs. Open surgery confirmed entrapment of the PCBm in one patient in the first group and all patients in the latter group.
Although clinical symptoms were not always reliable to diagnose entrapment of the PCBm in CTS, electrophysiological study of the PCBm was highly sensitive (75%) and entirely specific (100%) to demonstrate the entrapment of the PCBm preoperatively.
本研究旨在阐明正中神经掌皮支（PCBm）电生理数据在诊断与腕管综合征（CTS）并发的PCBm卡压中的意义。
对8例CTS患者大鱼际隆起异常感觉进行临床和电生理研究。采用顺行法，从前臂双极表面电极记录PCBm的感觉神经动作电位（SNAPs）。将术前SNAP评估结果与手术发现进行比较。
根据PCBm的SNAPs特征，8例患者分为两组；5例患者PCBm的SNAPs正常，3例患者SNAPs延迟或缺失。开放手术证实第一组中有1例患者以及后一组中的所有患者存在PCBm卡压。
尽管临床症状对于诊断CTS中PCBm卡压并不总是可靠的，但PCBm的电生理研究在术前显示PCBm卡压方面具有高度敏感性（75%）和完全特异性（100%）。
