Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands

Acta Neurol Scand. 1997 Oct;96(4):211-7. doi: 10.1111/j.1600-0404.1997.tb00271.x.


Objectives: To evaluate the following points about carpal tunnel syndrome (CTS): 1) characterization of a wide population; 2) sensitivity of electrodiagnostic tests, and particularly the contribution of disto-proximal ratio test; 3) validity of a neurophysiological classification developed by us.

Material and methods: Prospective study in 500 hands with CTS symptoms. Neurophysiological "standard" tests were always performed: sensory nerve conduction velocity (SNCV) first- and third digit-wrist and distal motor latency (DML). In "standard negative" hands disto-proximal ratio technique (R) was performed. Neurophysiological classification: Extreme CTS (absence of median motor, sensory responses), Severe (absence of sensory response, abnormal DML), Moderate (abnormal SNCV, abnormal DML), Mild (abnormal SNCV, normal DML), Minimal (abnormal R or other segmental/comparative test, normal standard tests).

Results: Sensibility of standard tests: 77%. R increased the diagnostic yield by 20%. CTS classification appeared reliable with significant differences between groups.

Conclusion: R is a useful test, the classification may be useful in clinical/therapeutical decisions.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / classification
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / physiopathology*
  • Electrodiagnosis*
  • Female
  • Hand / innervation*
  • Humans
  • Male
  • Median Nerve / physiopathology
  • Middle Aged
  • Motor Neurons / physiology
  • Neural Conduction / physiology
  • Reaction Time / physiology
  • Sensory Receptor Cells / physiology
  • Synaptic Transmission / physiology*