Evaluation Of The Compound Muscle Action Potential In Diagnosis Of The Mild Carpal Tunnel Syndrome

Year 2016, , 266 - 270, 01.12.2016

Veysel Alcan , Murat Zinnuroğlu Gülçin Kaymak Karataş Mehmet Rahmi Canal

https://doi.org/10.18100/ijamec.280468

Abstract

Carpal tunnel syndrome (CTS) is the most common entrapment
neuropathy. In most patients, the diagnosis can be proposed based on patient
history and clinical symptoms, with electrophysical findings. The mild CTS may
not produce any nerve conduction abnormalities and this can make standard
conventional tests not enough in diagnosis the mild CTS. The aim of this study
was to evaluate Compound Muscle Action Potential (CMAP) morphology as more sensitive
and specific parameters without any additional testing for diagnosis the mild
CTS. A total of seventy seven clinically diagnosed patients with CTS were
prospectively enrolled. Data was evaluated from seventy normal hands and forty
six hands with the diagnosis of the mild CTS with standard electrodiagnostic
(EDX) tests and clinical findings. The specificity and sensitivity rate were
calculated to evaluate the utility of CMAP negative peak (NP) morphology
parameters evaluated duration (CMAP NP_{Half-Duration} and CMAP NP_{Full-Duration})
and area (CMAP NP_Half-Area and CMAP NP_Full-Area) by
comparing the standard EDX test (Median Distal Motor Latency (DML) and peak to
peak amplitude of CMAP (CMAP NP_Amplitude) recorded from the abductor
policies brevis (APB) muscle. Although CMAP NP_{Half-Duration} and CMAP
NP_{Full-Duration} had no statistically significantly difference
between the mild CTS and normal group (p>0.05), DML, CMAP NP_Amplitude,
CMAP NP_Half-Area and CMAP NP_Full-Area in the mild CTS
group were statistically significantly different (p<0.05). The present study
shown CMAP NP_Full-Area had the highest sensitivity and moderate
specificity rate (90.0% and 42.2%, respectively). Furthermore, it was confirmed
again that DML was a valuable motor nerve conduction technique for the
diagnosis of the mild CTS with high sensitivity and moderate specificity (84.8%
and 47.6%, respectively), and it had more sensitive than CMAP NP_Half-Area high
sensitivity and moderate specificity (80.0% and 38.7%, respectively).This study
provided the evidence of CMAP NP_Full-Area and CMAP NP_Half-Area that
could be predictors of the mild CTS

Keywords

carpal tunnel syndrome, motor nerve conduction study, signal processing

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