Ghavanini M R, Haghighat M
Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.
Electromyogr Clin Neurophysiol. 1998 Oct-Nov;38(7):437-41.
A combination of 5 clinical tests: Tinel (9, 10), Phalen (wrist flexion) (1, 2, 17), reverse Phalen (wrist extension) (4), carpal compression (11, 18), vibration (13, 14) was used in 74 hands with symptoms of carpal tunnel syndrome and proved by median sensory conduction velocity and distal latency across wrist and compared with 58 normal hands. Tinel test was the most specific and the least sensitive, vibration test was the most sensitive and the least specific. Carpal compression test was less sensitive and specific compared to Durkan's study. There was no correlation between Phalen time, reverse Phalen time, carpal compression time, and nerve conduction measurements. Cases with positive Tinel and vibration tests has slower sensory nerve conduction velocity (SNCV) compared to cases with negative results. Also patients with positive vibration tests had longer duration of symptoms in comparison to patients with negative test results. Up to now electrodiagnostic studies are the standard in diagnosing carpal tunnel syndrome and determining severity of median nerve involvement at wrist.
对74例有腕管综合征症状且经腕部正中神经感觉传导速度和远端潜伏期证实的手部病例，使用了5项临床检查的组合：Tinel征（9, 10）、Phalen试验（屈腕）（1, 2, 17）、反Phalen试验（伸腕）（4）、腕部压迫试验（11, 18）、振动试验（13, 14），并与58例正常手部进行比较。Tinel征试验特异性最高但敏感性最低，振动试验敏感性最高但特异性最低。与Durkan的研究相比，腕部压迫试验的敏感性和特异性较低。Phalen试验时间、反Phalen试验时间、腕部压迫试验时间与神经传导测量之间无相关性。Tinel征试验和振动试验阳性的病例与阴性结果的病例相比，感觉神经传导速度（SNCV）较慢。此外，振动试验阳性的患者与试验结果阴性的患者相比，症状持续时间更长。到目前为止，电诊断研究是诊断腕管综合征和确定腕部正中神经受累严重程度的标准。
