Department of Neurology and Clinical Neurophysiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Clin Neurophysiol. 2012 Nov;123(11):2291-5. doi: 10.1016/j.clinph.2012.04.003. Epub 2012 May 16.
To test our hypothesis that comparing the sensory nerve conduction velocity of the median nerve across the wrist with that of the forearm is more sensitive than comparing it with that of the palm in the electrodiagnostic confirmation of carpal tunnel syndrome (CTS).
One hundred and fifty seven consecutive patients with clinically defined CTS were prospectively included and electrophysiologically examined. Antidromic nerve conduction velocities were measured in 3 segments of the median nerve: forearm, wrist, and palm. Differences and ratios in nerve conduction velocities were computed between the forearm and wrist and between the palm and wrist segments.
Comparing the median nerve conduction velocities of the forearm with the wrist segment provides a greater sensitivity (79.6% and 82.8% for the second and third digit, respectively) than comparing the palm with the wrist segment (65.6% and 65.0%). Applying the ratio leads to slightly higher sensitivities for both comparisons.
The modified segmental palmar test is a sensitive, robust and easily applicable method in diagnosing CTS.
We recommend to use the median nerve sensory conduction velocity in the forearm as a reference in the segmental palmar test instead of that in the palm.
检验我们的假设，即与手掌相比，比较腕部正中神经的感觉神经传导速度与前臂相比更能敏感地诊断腕管综合征（CTS）。
前瞻性纳入 157 例临床确诊为 CTS 的连续患者，并进行电生理检查。测量正中神经在 3 个节段的逆行神经传导速度：前臂、腕部和手掌。计算前臂和腕部以及手掌和腕部之间的神经传导速度差异和比值。
与手掌相比，比较前臂与腕部节段的正中神经传导速度具有更高的敏感性（第二和第三指分别为 79.6%和 82.8%）。应用比值会导致这两种比较的敏感性略有提高。
改良的节段性掌部测试是一种敏感、稳健且易于应用的 CTS 诊断方法。
我们建议在节段性掌部测试中使用前臂的正中神经感觉传导速度作为参考，而不是手掌的。
