Evolution of clinical, electrophysiological, and radiological aspects of the carpal tunnel syndrome before and after surgery

Acta Neurol Belg. 2017 Dec;117(4):903-908. doi: 10.1007/s13760-017-0837-0. Epub 2017 Sep 27.

Abstract

The aim of the study was to analyze the evolution of the clinical, electrophysiological, and ultrasound aspects of carpal tunnel syndrome (CTS) before and 4 and 8 weeks after surgery. A Boston Carpal Tunnel Questionnaire, an ultrasound scan, and an electrophysiological exam were performed in 14 patients the day of surgery, 4 and 8 weeks after. The nerve conduction study included: median nerve sensory conduction stimulating digit 3 and 4, median motor conduction from the abductor pollicis brevis, ulnar nerve sensory, and motor conduction. A significant improvement of the symptoms and a significant decrease of the median nerve proximal cross-sectional area on the ultrasound scan were observed 4 weeks after surgery. Distal motor latency (DML) was > 4.2 ms in six patients and decreased along the three visits. DML was ≤ 4.2 ms in the eight others and stayed stable after surgery. We observed a significant increase of the sensory median nerve amplitude response at the wrist stimulating the third digit 8 weeks after surgery. When operated patients are referred for control, we recommend to perform: (1) 4 weeks after surgery, an ultrasonography, and a measure of the DML of the median nerve; (2) 8 weeks after surgery, a measure of the sensory conduction velocity of the median nerve.

Keywords: Boston questionnaire; Carpal Tunnel; Electrophysiology; Surgery; Ultrasound.

MeSH terms

  • Adult
  • Aged
  • Carpal Tunnel Syndrome / diagnostic imaging*
  • Carpal Tunnel Syndrome / physiopathology
  • Carpal Tunnel Syndrome / surgery*
  • Female
  • Hand / physiopathology
  • Humans
  • Male
  • Median Nerve / diagnostic imaging
  • Median Nerve / physiopathology
  • Median Nerve / surgery*
  • Middle Aged
  • Motor Neurons / physiology
  • Muscle, Skeletal / physiopathology
  • Neural Conduction / physiology
  • Radiography* / methods
  • Treatment Outcome
  • Ultrasonography / methods