Chaurasia Rameshwar Nath, Kawale Sagar S, Pathak Abhishek, Mishra Vijaya Nath, Joshi Deepika
Department of Neurology, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
J Neurosci Rural Pract. 2017 Oct-Dec;8(4):575-580. doi: 10.4103/jnrp.jnrp_187_17.
The purpose of the study is to determine whether the clinical profile of patients with carpal tunnel syndrome (CTS) has been same over the years with the help of routine and comparative electrodiagnostic tests.
A prospective study of 100 patients with suspected CTS was conducted without controls. Three provocative maneuvers were performed. Routine and comparison nerve conduction tests were performed, i.e., second lumbrical interossei motor latency difference (2 LIMLD), digit 4 median-ulnar sensory latency difference (D4MUSLD), palm wrist distal sensory latency difference (PWDSLD), and digit 1 median-radial sensory latency difference (D1MRSLD). Data entry, analysis, and statistical evaluation were done using International Business Machines Corporation Statistical Package for the Social Sciences statistics package (IBM, SPSS).
A total of 195 hands of 100 patients met the criteria for CTS. Forty-three percentage of patients were homemakers. Considering the rapidly changing communication technology, we observed 84% patients had aggravation of symptoms with continuous long-term daily mobile phone use (>30 min per session per day). We noted positive Tinel's sign in only 25%. Phalen's sign was positive in 53 right hands with mean duration of 11.49s (standard deviation [SD] ± 2.54 s) and was positive in 26 left hands with mean being 10.4 s (SD ± 1.91 s). The mean motor distal latency of median was 4.67 ms (SD ± 1.71 ms) and mean sensory distal latency of median was 3.24 ms (SD ± 1 ms). On internal comparison testing, mean difference in 2 LIMLD was 0.7 ± 0.3 ms, in D4MUSLD was 0.81 ± 0.32, in PWDSLD was 0.71 ± 0.20, and in D1MRSLD was 0.76 ± 0.32.
Further analysis of clinical profile needs to be done, and new risk or provoking factors should be analyzed in patients with CTS.
本研究旨在借助常规和对比性电诊断测试，确定多年来腕管综合征（CTS）患者的临床特征是否相同。
对100例疑似CTS患者进行前瞻性研究，未设对照组。进行了三种激发动作。进行了常规和对比性神经传导测试，即第二蚓状肌骨间肌运动潜伏期差异（2 LIMLD）、第4指正中神经-尺神经感觉潜伏期差异（D4MUSLD）、手掌腕部远端感觉潜伏期差异（PWDSLD）以及第1指正中神经-桡神经感觉潜伏期差异（D1MRSLD）。使用国际商业机器公司社会科学统计软件包（IBM，SPSS）进行数据录入、分析和统计评估。
100例患者的195只手符合CTS标准。43%的患者为家庭主妇。考虑到通信技术的快速变化，我们观察到84%的患者因持续长期每日使用手机（每次会话>30分钟/天）而症状加重。我们仅在25%的患者中发现阳性Tinel征。Phalen征在53只右手呈阳性，平均持续时间为11.49秒（标准差[SD]±2.54秒），在26只左手呈阳性，平均持续时间为10.4秒（SD±1.91秒）。正中神经运动远端潜伏期平均为4.67毫秒（SD±1.71毫秒），正中神经感觉远端潜伏期平均为3.24毫秒（SD±1毫秒）。在内部对比测试中，2 LIMLD的平均差异为0.7±0.3毫秒，D4MUSLD为0.81±0.32，PWDSLD为0.71±0.20，D1MRSLD为0.76±0.32。
需要对临床特征进行进一步分析，并应对CTS患者的新风险或诱发因素进行分析。
