Association analysis of electroneurography and boston questionnaire in patients with carpal tunnel syndrome

Year 2015, Volume: 6 Issue: 2, 72 - 76, 12.09.2015

Esra İnal Pınar Eroğlu

Abstract

Objective:The aim of the study to clarify the relationships between Electroneurography (ENG) and Boston Questionnaire (BQ) in patients with Carpal Tunnel Syndrome (CTS)
Material-Method:One hundred and forty-one patients with CTS were enrolled to this study. The demographic data as age, gender, body mass index, symptoms duration and night pain of the patients were recorded. Tinel and Phalen tests were noted as positive or negative. The scores of the BQ Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) were measured. Pain was assessed on Visual Analog Scale (VAS). Motor and antidromic sensory conduction velocities of the median and ulnar nerves were performed. Patients were divided to three groups as mild, moderate and severe CTS according to the ENG outcomes.
Results:The scores of the VAS pain and the BQ-FSS and SSS were found to be significantly higher in patients with moderate and severe CTS compared to those in mild CTS (p<0.005). The scores of BQ-FSS and SSS were correlated moderately with the duration of symptoms, median sensory nerve action potential(SNAP)-palm and second digit and strongly with VAS pain (p<0.05). We found BQ-SSS scores also correlated moderately with median distal motor latency(DML), and sensory nerve conduction velocity(SCNV)-palm and second digit (p<0.05).
Discussion:The patients who have different clinical findings however similar pictures may be interpreted in the light of these results. Namely when the clinician meet decreased median SNAP or elevated median DML and SCNV, he/she should be careful on both the symptom severity and functional impairment or only functional deficiency respectively.

Keywords

Carpal tunnel syndrome, Electroneurography, Boston questionnaire

Karpal tünnel sendromlu hastalarda elekronörografi ile boston anketi arasındaki ilişkilerin analizi

Abstract

Amaç: Bu çalışmanın amacı, Karpal Tünel Sendrom(KTS)'lu hastalarda elektronörografi (ENG) ile Boston Anketi (BA) arasındaki ilişkileri saptamaktır.
Materyal-Metot: Karpal tünel sendromlu yüz kırk bir hasta çalışmaya dahil edilmiştir. Hastaların yaş, cinsiyet, vücut kitle indeksi, semptom süresi ve gece ağrısı gibi demografik bulguları kaydedildi. Tinel ve Phalen testleri negative veya pozitif olarak not edildi. BA Semptom Ciddiyet Skalası (SCS) ve Fonksiyonel Ciddiyet Skalası(FCS)'nın skorları belirlendi. Ağrı Vizüel Analog Skala (VAS) üzerinde değerlendirildi. Median ve ulnar sinirlerin motor ve antidromik duyusal iletim çalışmaları gerçekleştirildi. Hastalar ENG ciddiyetine göre hafif, orta ve ağır KTS olarak 3 gruba ayrıldılar.
Bulgular: Orta ve ciddi KTS'lu hastalarda hafif KTS'lu hastalardakine kıyasla VAS ağrı ve BA-SCS ve FCS skorları anlamlı olarak yüksek bulundu (p<0.005). BA-SCS ve FCS skorları, semptom süresi, median duyusal sinir aksiyon potansiyeli(DSAP)-avuçiçi ve ikinci parmak ile orta şiddette ve VAS ağrı ile güçlü olarak korele idi (p<0.05). Ayrıca, BA-SCS skorlarının median distal motor latans (DML) ve median duyusal sinir iletim hızı(DSİH)-avuçiçi ve ikinci parmak ile orta düzeyde korele olduğunu bulduk (p<0.05).
Tartışma: Farklı klinik bulguları ancak benzer klinik tabloya sahip olan hastalar bu sonuçlar ışığında değerlendirilebilirler. Yani, klinisyen azalmış median DSAP veya artmış median DML ve DSİH karşılaştığında, sırasıyla hem semptom ciddiyeti ve hem de fonksiyonel eksiklik veya sadece fonksiyonel kayıp üzerinde dikkatli olmalıdır.

Keywords

Karpal tünel sendromu, Elektronörografi, Boston anketi

References

• Yazdanpanah P, Aramesh S, Mousavizadeh A, Ghaffari P, Khosravi Z, Khademi A. Prevalence and severity of carpal tunnel syndrome in women. Iran J Public Health 2012; 41(2): 105-110.
• 2 Randal LB, Ralph MB, Leighton C et al. Physical Medicine and Rehabilitation, 3rd ed. Philadelphia: Elsevier Saunders; 2.007, 1079-1080.
• de Krom MC, Knipschild PG, Kester AD, Thijs CT, Boekkooi PF, Spaans F. Carpal tunnel syndrome: prevalence in the general population. J Clin Epidemiol 1992; 45(4): 373- 376.
• Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999; 282(2): 153-158.
• Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JN. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993; 75(11): 1585-1592.
• American Association of Electrodiagnostic Medicine, American Academy of Neurology, and American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 2002; 25(6): 918-922.
• Karadağ YS, Karadağ O, Ciçekli E, Oztürk S, Kiraz S, Ozbakir S, Filippucci E, Grassi W. Severity of Carpal tunnel syndrome assessed with high frequency ultrasonography. Rheumatol Int 2010; 30(6): 761-765.
• Kim MK, Jeon HJ, Park SH, Park DS, Nam HS. Value of ultrasonography in the diagnosis of carpal tunnel syndrome: correlation with electrophysiological abnormalities and
• clinical severity. J Korean Neurosurg Soc 2014; 55(2): 78-82. 9 Park KM, Shin KJ, Park J, Ha SY, Kim SE. The usefulness of terminal latency index of median nerve and f-wave difference between median and ulnar nerves in assessing the severity of carpal tunnel syndrome. J Clin Neurophysiol 2014; 31(2): 162-168.
• Mondelli M, Reale F, Sicurelli F, Padua L. Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically- treated carpal tunnel syndrome. J Hand Surg Br 2000; 25(2): 128-134.
• Semiha KURT, Betül ÇEVİK, Yüksel KAPLAN, Hatice Karaer, Ünal Erkorkmaz. Karpal Tünel Sendromunda Boston Sorgulama Formu ve Elektrofizyolojik Bulgular Arasındaki İlişki. Nöropsikiyatri Arşivi 2010; 47: 237-240.
• Kuschner SH, Ebramzadeh E, Johnson D, Brien WW, Sherman R. Tinel’s sign and Phalen’s test in carpal tunnel syndrome. Orthopedics 1992; 15(11): 1297-1302.
• El Miedany Y, Ashour S, Youssef S, Mehanna A, Meky FA. Clinical diagnosis of carpal tunnel syndrome: old tests- new concepts. Joint Bone Spine 2008; 75(4): 451-457.
• Sezgin M, Incel NA, Serhan S, Camdeviren H, As I, Erdoğan C. Assessment of symptom severity and functional status in patients with carpal tunnel syndrome: reliability and functionality of the Turkish version of the Boston Questionnaire. Disabil Rehabil 2006; 28(20): 1281-1285.
• Akman S, Ertürer E, Celik M, Aksoy B, Gür B, Oztürk I. The results of open surgical release in carpal tunnel syndrome and evaluation of follow-up criteria. Acta Orthop Traumatol Turc 2002; 36(3): 259-264.