Carpal Tunnel Syndrome PIP Clinical Module - Stage 2-Practice Parameter and Literature Review of the Usefulness of Nerve Conduction Studies and Needle Electromyography for the Evaluation of Patients with Carpal Tunnel Syndrome

Practice Parameter and Literature Review of the Usefulness of Nerve Conduction Studies and Needle Electromyography for the Evaluation of Patients with Carpal Tunnel Syndrome

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Pdf Summary

Carpal tunnel syndrome (CTS) is a common clinical problem that often requires surgical therapy. Electrodiagnostic (EDX) studies have been found to be highly sensitive and specific in the diagnosis of CTS. This document, published by the American Association of Electrodiagnostic Medicine, provides recommendations for EDX studies in CTS based on a critical review of the literature. The document defines the standards, guidelines, and options for EDX studies of CTS. The recommendations are as follows:<br /><br />1. Perform a median sensory nerve conduction study across the wrist, comparing the result to sensory nerve conduction studies of adjacent nerves, if abnormal.<br /><br />2. If the initial median sensory nerve conduction study is normal, additional studies may be performed, such as comparison of sensory or mixed nerve conduction studies across the wrist or comparison of median sensory nerve conduction to radial or ulnar sensory nerve conduction.<br /><br />3. Motor nerve conduction studies of the median nerve recording from the thenar muscle, as well as one other nerve in the symptomatic limb, should be performed.<br /><br />4. Supplementary studies, such as median motor nerve distal latency, median motor nerve terminal latency index, short segment incremental median sensory nerve conduction, and needle electromyography may also be considered.<br /><br />The document also provides recommendations for future research studies in CTS, including the use of prospective study design, clinical diagnosis of CTS independent of EDX studies, and a uniform protocol for data collection and measurement. The document emphasizes the importance of reliable and reproducible data to evaluate the usefulness of EDX studies in confirming the clinical diagnosis of CTS.

Keywords

Carpal tunnel syndrome

CTS

Electrodiagnostic studies

American Association of Electrodiagnostic Medicine

Median sensory nerve conduction study

Motor nerve conduction studies

Needle electromyography

Prospective study design

Clinical diagnosis of CTS

Data collection

CTS

carpal tunnel syndrome