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Carpal tunnel syndrome (CTS) is the most common cause of peripheral compressive neuropathy and consists of compression of the median nerve in the wrist. Although there are several etiologies, idiopathic is the most prevalent origin, and among the forms of treatment for CTS, conservative is the most indicated. However, despite the high prevalence in and impact of this syndrome on the healthcare system, there are still controversies regarding the best therapeutic approach for patients. Therefore, noting that some studies point to vitamin D deficiency as an independent risk factor, which increases the symptoms of the syndrome, this study evaluated the role of vitamin D supplementation and its influence on pain control, physical examination and response electroneuromyography to conservative treatment of carpal tunnel syndrome. For this, the sample consisted of 14 patients diagnosed with CTS and hypovitaminosis D, who were allocated into two groups. The control group received corticosteroid treatment, while the experimental group received corticosteroid treatment associated with vitamin D. Thus, from this study, it can be concluded that patients who received vitamin D, when compared to those who did not receive it, showed improvement in the degree of pain intensity, a reduction in symptom severity and an improvement in some electroneuromyographic parameters.

Aim: In this study, we aimed to investigate frequency of de Quervain's tenosynovitis (DQT) in patient with idiopathic carpal tunnel syndrome (ICTS)., Material and Methods: We evaluated 356 hands of 310 patients who applied with the pre-diagnosis of ICTS. Patients who have pain over the radial styloid, pain on movement, tenderness over the first dorsal extensor compartment and also positive Finkelstein's test were accepted clinically DQT. Presence of DQT was confirmed by ultrasonography. Motor and sensory conductions of median and ulnar nerves were studied in every hand with the pre-diagnosis of ICTS., Results: We determined ICTS in 302 (85%) hands. De Quarvain's tenosynovitis ratio was found to be 9.9% in hands with ICTS (n:302). In patients with ICTS and DQT in the same hand, the male-to-female ratio is 1/3. There were 29 cases (22 female, 7 male) with ICTS and DQT. Of the 30 hands with ICTS and DQT together; 18 had mild, nine had moderate, and 3 had severe ICTS., Conclusion: This is the first study that evaluates the DQT and ICTS together. We found that patients with ICTS have a prevalence higher than normal population to have DQT. We suppose that considering DQT in patients with the pre-diagnosis of ICTS during clinical evaluation has a positive impact on clinical follow-up and treatment of these patients.

Carpal tunnel syndrome (CTS) is too common a condition not to daily interact with the practitioner, if only because of its entanglement to other pathologies, causal or chance association. The typical symptomatology, with hand paresthesia and morning pain upon waking, is related to a median nerve injury in the confined space of the carpal tunnel, more often by local inflammation and tenosynovitis of the finger flexors (repetitive activity of the hands). SCC may be secondary to situations (pregnancy) or conditions (edema, hypothyroidism…), which exaggerate the ordinary pathophysiology or cause deposits in the channel (amyloidosis, mucopolysaccharidoses, etc.). Otherwise, SCC is favored by all neuropathies that cause nerve fragility (especially diabetes). It is sometimes the first sign of these various affections of which it can allow early diagnosis. Electroneuromyographic examination (ENMG) is a key examination to confirm the diagnosis (slowing of sensitive and motor conduction of the median nerve through the carpal tunnel, due to local demyelination), to look for a predisposing neuropathy and for signs of seriousness (amplitude reduction of electrophysiological signals) that indicate axonal loss. In SCC forms with only slowed conduction without sign of seriousness, a splint or infiltration treatment may be attempted. If this medical treatment does not bring healing, or if there are signs of seriousness or unbearable pains, a decompression surgery is indicated. Whether it is performed traditionally or endoscopically, it provides fast relief, even immediate., (Copyright © 2020 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

This study aims to evaluate the advantages of ultrasound in the diagnosis of carpal tunnel syndrome by comparing it with electroneuromyography (ENMG). We conducted a cross-sectional study over a period of 6 months. All patients underwent ultrasound with measurement of the surface of the median nerve at the entrance of the carpal tunnel and electroneuromyographic examination of both wrists. The sensitivity and specificity of ultrasound was compared to those of ENMG. The average age of patients was 49.6 years with a clear female predominance (98%). The majority of patients were housewives. Paresthesias were the most common reason for consultation in 86%. Bilateral clinical manifestation occurred in 78% of cases. ENMG showed pathological result in 89 wrists (89%). Ultrasound was abnormal in 63 wrists (63%) with a median surface area of the median nerve of 11 mm 2 . This study highlights an ultrasound sensitivity of 70%, a specificity of 100% with a positive predictive value (PPV) of 100% and a negative predictive value (VPN) of 29.7%. It was concluded that ultrasound has sensitivity only to carpel tunnel with severe involvement on ENMG., Competing Interests: Les auteurs ne déclarent aucun conflit d'intérêts., (© Siham Bouchal et al.)

Carpal tunnel syndrome (CTS) is the most frequently diagnosed neuropathy of upper extremity entrapment neuropathies. We aimed to investigate the effectiveness of paraffin therapy in patients with CTS. Seventy patients diagnosed with mild or moderate CTS were randomly divided into two groups as splint treatment (during the night and day time as much as possible for 3 weeks) alone and splint (during the night and day time as much as possible for 3 weeks) + paraffin treatment (five consecutive days a week for 3 weeks). Clinical and electrophysiological assessments were performed before and 3 weeks after treatment. The patients were assessed by using visual analog scale (VAS) for pain, electroneuromyography (ENMG), and Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ). The significant improvement was found in VAS scores in both groups when compared with pretreatment values (p < 0.05). There was no significant improvement in functional capacity score (p > 0.05), whereas a significant improvement was noted in the BCTQ symptom severity scale score in the splint group (p < 0.05). Significant improvements were demonstrated in both scorers in the combined treatment group. Similarly, significant improvements were found in the combined treatment group in terms of motor and sensory distal latency, sensory amplitude, and median sensory nerve velocity (p < 0.05). There was no significant change in electrophysiologic parameters in the splint group (p > 0.05), and the difference in these parameters between the groups was statistically significant (p < 0.05). In conclusion, using splinting alone in patients with CTS is an effective treatment for reducing symptoms in the early stages. Paraffin treatment with splint increases the recovery in functional and electrophysiological parameters.

Carpal tunnel syndrome(CTS) is the most common neuromuscular cause of upper extremity disability. We aimed to investigate the effectiveness of peloid therapy in patients with CTS. This randomized, controlled, single-blind study enrolled 70 patients between the ages of 30 to 65 who had a diagnosis of either mild, mild-to-moderate, or moderate CTS. The patients were randomized into two groups using random number table. In the first group, (Group 1)(n = 35), patients were given splint (every night for 6 weeks) + peloid treatment(five consecutive days a week for 2 weeks) and in the second group, (Group 2)(n = 28), patients received splint treatment(every night for 6 weeks) alone. The patients were assessed by using visual analog scale(VAS) for pain, electroneuromyography(ENMG), the Boston Carpal Tunnel Syndrome Questionnaire(BCTSQ), hand grip strength(HGS), finger grip strength(FGS), and Short Form-12(SF-12). The data were obtained before treatment(W0), immediately after treatment(W2), and one month after treatment(W6). Both in Group 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0(p < 0.05). Comparison of the groups with each other revealed significantly better results for VAS, BCTSQ, mSNCV, SF-12 in Group 1 than in Group 2 at W2(p < 0.05). There was also a statistically significant difference in favor of Group 1 for VAS, BCTSQ, FGS and MCS at W6 when compared to W0 (p < 0.05). The results of our study demonstrated that in patients with CTS; peloid + splint treatment was more effective than splint treatment alone in pain, functionality and life quality both at after treatment(W2) and one month after treatment (W6). We may suggest peloid as a supplementary therapeutic agent in CTS.

Aim: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy resulting from compression of the median nerve at the wrist level. Increased intercarpal canal pressure plays an important role in the etiology of CTS. Although most cases are idiopathic, there may also be some systemic or local causes. The aim of this study was to evaluate the demographic and etiological characteristics of patients with CTS who applied to our electroneuromyography (ENMG) laboratory within 3 months. Material and Methods: One hundred forty-nine patients (=298 hands) who were sent to our ENMG laboratory for ENMG evaluation and diagnosed with CTS were included in our study. Cases with cervical vertebral root lesions, thoracic outlet syndrome, polyneuropathy, trauma such as nerve injury, and cases with tumors and secondary CTS to pregnancy were excluded from the study. Results: One hundred six (71.1%) of the cases in our study were women and 43 (28.9%) were men. The average age of the patients was 54.27±13.10, and the body mass index (BMI) was 27.92±3.98. BMI ≥30 was found in 47 (31.5%) of the patients. In our study, we found that housewives were the occupational group with the highest risk in terms of CTS (n=94, 63.1%). In this study, we found bilateral hand involvement in 93 (62.4%) patients. The most common condition was idiopathic CTS (n=81, 54.6%). Conclusion: CTS is more common in postmenopausal women who work as housewives and is usually seen in the dominant hand. It was concluded that this study would be useful for the diagnosis of CTS. [ABSTRACT FROM AUTHOR]

Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy and presents with symptoms such as pain, paresthesia, and weakness in the elbow. Provocative tests and electrophysiological examinations are helpful in the diagnosis of UNE. Low-level laser therapy is one of the conservative treatments of UNE however, limited results were reported on the effectiveness of low-level laser therapy (LLLT) in the treatment of UNE. In our study, we aimed to the efficacy of LLLT in reducing symptoms and providing clinical and electrophysiological improvement in patients with UNE. This study with a randomized-sham controlled, and double-blind design included 68 patients aged 18–60 years who were diagnosed with UNE. LLLT was applied to the first group, and sham laser was applied to the second group. The VAS pain, paresthesia, and weakness scores, grip strength, and provocative test positivity were evaluated in clinical examination. The QuickDASH questionnaire was administered to assess functional status. Electrophysiologically, motor distal latency (MDL) differences, sensory distal latency (SDL), motor and sensory nerve conduction velocity (NCV) were examined. Evaluations were performed before treatment and on the 15th day and at the third month after treatment. The LLLT group showed improvement in symptoms, clinical findings, motor NCV, and MDL at both post-treatment evaluations and sensory NCV on the post-treatment 15th day (p < 0.05). The comparison of post-treatment changes between the two groups revealed that the LLLT group had greater improvement in VAS day and night pain scores at both post-treatment evaluation times, QuickDASH scores at the third month, and sensory NCV on the 15th day (p < 0.05) compared to the SL group. There were no significant differences between the groups in terms of the post-treatment changes in VAS weakness scores, grip strength and electrophysiological findings (p > 0.05). It was observed that splinting alone was effective in UNE, but the addition of LLLT, one of the conservative treatment methods, enhanced treatment outcomes. [ABSTRACT FROM AUTHOR]

Background and aim: Carpal tunnel syndrome (CTS) is a compressive neuropathy caused by compression of the median nerve in the carpal tunnel. It is the most common entrapment neuropathy. According to different studies, the prevalence of CTS among adults (15–65 years old) in Western Europe ranged from 0.29% to 43%. CTS affects middle-aged active workers and is associated with high healthcare costs and a hefty economic burden. It is thus essential to diagnose CTS early and refer the patient to further investigation and treatment. In this study, we aimed to evaluate the accuracy of the clinical CTS diagnosis before the nerve conduction studies were performed on the referred patients.Methods: The concordance of clinical diagnoses was assessed by comparing referral diagnoses with diagnoses confirmed by electroneuromyography. All the patients referred for electroneuromyography to Mykolas Marcinkevičius Hospital between August 2023 and February 2024 were included in this research. The age, sex, referral and final diagnoses of the enrolled patients were taken from their outpatient charts. The obtained data were summarized and processed with Microsoft Office Excel 365, and the data analysis was performed with IBM SPSS Statistics.Results: The most common reasons that patients were referred to perform NCS were suspected carpal tunnel syndrome (30.7%), cubital tunnel syndrome (13.5%), other upper extremity mononeuropathies (16.2%), and polyneuropathies (15.5%). The most common diagnosis after consultation was carpal tunnel syndrome (42.6%), followed by pathologies of nerve roots or plexuses (14.5%). Out of 91 patients referred to electroneurography due to suspicion of CTS, 67 (73.6%) were confirmed cases, whereas, for 12 (13.2%) patients, no abnormalities were detected during NCS.Conclusion: Our analysis supports the theory that the electrodiagnostic examination is essential to specify and confirm the diagnosis of CTS, thus avoiding hyperdiagnosis and preventing patients from excessive surgical treatment.

Background. Carpal tunnel syndrome is the most common and widespread peripheral neuropathy in the world. The diagnostic testing methods for the carpal tunnel syndrome are based on anamnesis data, objective and instrumental inspection. Electroneuromyography is the main instrumental test when carpal tunnel syndrome is suspected. An ultrasound imaging may also be performed. Objective. To determine the effectiveness, sensitivity and specificity of instrumental diagnostics methods used to diagnose the carpal tunnel syndrome, and to compare them. Methods. Diagnostic testing – ultrasound and electroneuromyography was applied to persons under study. The area of the median nerve (mm2) was assessed during the ultrasound examination. The results of the electroneuromyography study evaluated the response speed of the sensory impulse (ms), the speed of the motor impulse response (ms). Later, the tests, their sensitivity and specificity were evaluated and compared. Results. 30 patients participated in the study, of which 26 (86.7%) were women, 4 (13.3%) were men. Electroneuromyography was found to be both sensitive and specific for a measure of sensory propagation velocity, 76.2 and 75%, respectively (p = 0.042); of motor propagation speed – 100 and 75% (p = 0.040). Ultrasonography is sensitive (87.5%) but nonspecific (66.7%) (p = 0.008). The study showed that the ultrasound dimension strongly, directly and reliably correlates with the sensory impulse response rate (p

Background. Carpal tunnel syndrome is the most common and widespread peripheral neuropathy in the world. The diagnostic testing methods for the carpal tunnel syndrome are based on anamnesis data, objective and instrumental inspection. Electroneuromyography is the main instrumental test when carpal tunnel syndrome is suspected. An ultrasound imaging may also be performed. Objective. To determine the effectiveness, sensitivity and specificity of instrumental diagnostics methods used to diagnose the carpal tunnel syndrome, and to compare them. Methods. Diagnostic testing – ultrasound and electroneuromyography was applied to persons under study. The area of the median nerve (mm²) was assessed during the ultrasound examination. The results of the electroneuromyography study evaluated the response speed of the sensory impulse (ms), the speed of the motor impulse response (ms). Later, the tests, their sensitivity and specificity were evaluated and compared. Results. 30 patients participated in the study, of which 26 (86.7%) were women, 4 (13.3%) were men. Electroneuromyography was found to be both sensitive and specific for a measure of sensory propagation velocity, 76.2 and 75%, respectively (p = 0.042); of motor propagation speed – 100 and 75% (p = 0.040). Ultrasonography is sensitive (87.5%) but nonspecific (66.7%) (p = 0.008). The study showed that the ultrasound dimension strongly, directly and reliably correlates with the sensory impulse response rate (p < 0.001), and the ultrasound dimension moderately, directly and reliably correlates with the motor impulse response rate (p < 0.001). Conclusions. Carpal tunnel syndrome can be suspected by ultrasound measurement of the area of the median nerve, but the test is only sensitive but non-specific. Electroneuromyography can confirm the diagnosis of carpal tunnel syndrome, as the test is both sensitive and specific. Comparing the studies, a strong, direct and reliable relationship between the results of the ultrasound and the electroneuromyography testing was established. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Exercise is a major factor in the development of occupational pathology of the connective tissue and musculoskeletal system, including chronic lumbosacral radiculopathy (LSRP), which accounts for 20% of occupational diseases in Ukraine. Some problems remain insufficiently studied despite a significant number of scientific works devoted to the study of issues of etiology, pathogenesis, features of clinical manifestations, the use of diagnostic and prophylactic measures in LSRP. The criteria for diagnosing changes in the peripheral nervous system need to be clarified and systematized by in-depth study of the functional state of the nervous apparatus in patients with LSRP of professional genesis. The research was carried out in a group of 60 miners of the main professions (coal-cutter, mining worker of a clearing pit (MWCP), drifter) suffering from LSRP. The activity of the neuromuscular apparatus was assessed according to the indices of electroneuromyography (ENMG), namely: the amplitude of the M-response during stimulation at the distal point of the right and left m. Abductor Hallucis, n. Plantar Medial, S1, S2 (mV), as well as indicators of terminal and residual latencies (ms), the speed of the impulse along the indicated nerves (m/s). It was found that the average amplitude of the M-response during stimulation at the distal point m. Abductor Hallucis, n. Plantar Medial in the MWCF group was at 6.37 mV (with a reference value of 4-5.8 mV), the average pulse conduction velocity was 38.46 m/s (with a reference value of 40.00 -50.00 m/s), it was found that most often in the group of coal-cutters (64.2%), a pathological indicator of terminal latency was recorded, while in a group of drifter, it did not go beyond the normal range in one of the surveyed miners suffering from LSRP of occupational genesis. Thus, ENMG of the long nerves of the lower extremities is a useful tool of objectifying the diagnosis of LSRP of ocupational genesis, it allows to determine the degree of impairment of the functional activity of peripheral nerves, neuromuscular synapses and the contractility of the striated muscles. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to compare the effectiveness of radial extracorporeal shock wave therapy and local corticosteroid injection on pain, function, and nerve conduction studies in the treatment of idiopathic carpal tunnel syndrome. Design: A total of 72 patients who were diagnosed as having carpal tunnel syndrome were included in the study. The radial extracorporeal shock wave therapy group received radial extracorporeal shock wave therapy, the local corticosteroid injection group received local corticosteroid injection, and the control group only used a resting hand splint. The patients were evaluated using a Visual Analog Scale–pain, a Visual Analog Scale–numbness, the Boston Symptom Severity Scale, the Boston Functional Status Scale, and handgrip strength tests before treatment 1 and 12 wks after the treatment. Results: Both clinical and nerve conduction study parameters improved with all three groups, and this effect continued at the 12th-week follow-up of the patients. The Visual Analog Scale–pain, Visual Analog Scale–numbness, Boston Symptom Severity Scale, and Boston Functional Status Scale scores in the first week after the treatment, as well as Visual Analog Scale–pain and Boston Functional Status Scale scores in the 12th week after the treatment, were significantly lower in the local corticosteroid injection group compared with the other two groups. Conclusions: Our study revealed the success of radial extracorporeal shock wave therapy, splint, and local corticosteroid injection, but symptom relief was greater in the first week and 12th week with local corticosteroid injection. [ABSTRACT FROM AUTHOR]

Abstract Objective To verify whether there is an association between the results of the severity in electroneuromyography and the positivity in ultrasound in the diagnosis of carpal tunnel syndrome. Methods Sixty-eight patients were included in the study, 61 women and 7 men, with a mean age of 54.4 years. The ultrasound results (positive or negative) were crossed with the results of electroneuromyography (mild, moderate or severe), and the existence of association was verified. Results One hundred and thirty-six hands with suspicion or symptoms of carpal tunnel syndrome were evaluated. Positive ultrasound diagnosis was observed in 72 hands and negative in 64; 123 hands presented positive electroneuromyography for carpal tunnel syndrome, and there were 13 negative results. The severe degree in electroneuromyography was prevalent. Conclusion There was a statistically significant association between electroneuromyography and ultrasonography (p < 0.05), and ultrasound positivity was higher for more severe levels of carpal tunnel syndrome given by electroneuromyography.

Introduction. Carpal tunnel syndrome (CTS) is the most frequent tunnel neuropathy. Local injection of corticosteroids (CS) and wrist splinting are used to treat CTS. The optimal frequency of local CS injections has not been determined. The aim of this study was to carry out a comprehensive (clinical, electrophysiological, and ultrasound) evaluation of the effect duration of a single local injection of corticosteroid with lidocaine in patients with mild and moderate CTS, in combination with regular wrist splinting for 6 months. Materials and methods. Changes in the clinical, neurophysiological, and ultrasound parameters were analyzed in 44 cases of mild and moderate CTS after a single local administration of CS and the use of regular wrist splinting. The results of Tinels test, Phalens test, and the Boston Questionnaire, median nerve conductivity based on electroneuromyography data, cross-sectional area of the nerve at the entrance to the carpal tunnel, and the degree of nerve flattening on ultrasound were assessed before treatment and within six months after injection. Results. Within 6 months following injection, all patients noted a significant improvement in the clinical condition. The greatest clinical effect occurred in the first 2 months, after which the objective signs of improvement stabilized or gradually regressed. Clinical symptoms, nerve conduction values, and the cross-sectional area remained stably improved for 6 months, while the amplitude of motor and sensory responses remained stable for 2 months. Conclusion. In mild and moderate CTS, local injection of CS and lidocaine plus splinting provides the maximum improvement in clinical, electrophysiological, and ultrasound parameters for the first 2 months. We hypothesize that a further improvement in objective results is possible with a repeat injection after 2 months.

INTRODUCTION[|]Carpal tunnel syndrome (CTS) is the most common and best studied of all focal neuropathies. CTS is a clinical syndrome of numbness, tingling, burning, and/or pain associated with localized compression of the median nerve at the wrist.[¤]METHODS[|]A total of 49 hands of 32 patients who presented at the electrophysiology laboratory of the clinic due to suspected CTS were prospectively enrolled in the study. The patients were evaluated using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale and a visual analog scale (VAS). The LANSS pain scale is an instrument designed for use in a clinical setting to identify patients whose pain is dominated by neuropathic mechanisms. VAS is a subjective register of pain: On a 100-mm horizontal scale, 0 indicates no pain, while 100 indicates maximum pain. The patients were diagnosed using electrophysiology and grouped as mild, moderate, and severe CTS. LANSS pain scale values above 12 and below 12 were compared according to the severity of CTS. The VAS was applied separately to the right hand and left hand. LANSS and VAS results were compared separately.[¤]RESULTS[|]The LANSS pain scale value was found to be 12 or more in cases of mild and severe CTS. The response to the LANSS question related to discoloration (item 2) was greater in the patients with a LANSS score ≥12 (p=0.008), and similarly, the allodynia (item 6) response was significantly higher in the same group (p=0.010). Except for these 2 items, there was no significant difference between patients with a LANSS score of

Halil Ay Neurology Department of Medical Faculty, Harran University, Sanliurfa, Turkey Abstract: Hirayama disease (HD) is a rare motor neuron disorder that involves a single upper extremity. It is clinically characterized by weakness and atrophy of the muscles of the hand and forearm. This article presents a 19-year-old woman who visited the orthopedics outpatient clinic with weakness and atrophy in her right hand and was clinically diagnosed with advanced stage carpal tunnel syndrome and scheduled for surgical intervention; she was later diagnosed with HD by an electrophysiological study. As a result, it has been found that a careful electrophysiological study and neurological examination can be used to diagnose HD. In this way, advanced stage carpal tunnel syndrome will be ruled out and patients will be spared from an unnecessary surgical operation. Keywords: Hirayama disease, carpal tunnel syndrome, electroneuromyography, motor neuron disorder, thenar atrophy, compound muscular action potential

Objectives: This study aims to investigate whether or not radial deviation developing after wrist involvement of rheumatoid arthritis (RA) is a cause of median nerve swelling. Patients and methods: The study included 51 RA patients (12 males, 39 females; mean age 50.9±8.9 years; range, 18 to 65 years) without carpal tunnel syndrome (CTS) detected by electroneuromyography. Duruöz hand index, visual analog scale, and painDETECT questionnaire were performed in clinical assessment. Radiographic measurements including radial inclination (RI) angle were performed. Using ultrasonography, the median nerve cross-sectional areas (CSAs) were measured from the four levels of the distal one third of the forearm, radioulnar joint, pisiform bone, and hook of hamate, while the ulnar nerve CSAs were measured from the pisiform bone. Results: The study was completed with 102 hands of 51 patients. A negative correlation was found between the RI and the median CSAs measured from the radioulnar joint (R=-0.49; p=0.00), the pisiform bone (R=-0.45; p=0.00), and hook of hamate (R=-0.60, p=0.00). When the hands were divided into three groups according to the ranges of RI specified in the literature, the median nerve CSA was found to be significantly higher in the group with low RI at these levels (p<0.001). Conclusion: In patients with RA without CTS, the increase in the median nerve CSAs may be associated with radiographic measures such as radial deviation. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article gives an overview of modern diagnostic methods compression-ischemic neuropathy of the median nerve at the carpal tunnel. The etiology, clinical presentation and classification of the disease. We present the clinical and instrumental features of the manifestation of carpal tunnel syndrome. Given the possibilities and limitations of both basic research methods (EMG and ENMG) and highly informative modern techniques (MRI), as well as high-resolution ultrasound in the diagnosis of compression of the median nerve.

Surface sensitivity disorders are observed in many diseases of the central and peripheral nervous system. Surface sensitivity thresholds were estimated in healthy individuals and patients with carpal tunnel syndrome. There was a statistically significant (p < 0.001) increase in the sensitivity threshold in the distal phalanx of the index finger in patients with carpal tunnel syndrome as compared to healthy individuals, by evaluating the surface sensitivity by Semmes–Weinstein monofilaments.

Carpal tunnel syndrome(CTS) is the most common neuromuscular cause of upper extremity disability. We aimed to investigate the effectiveness of peloid therapy in patients with CTS. This randomized, controlled, single-blind study enrolled 70 patients between the ages of 30 to 65 who had a diagnosis of either mild, mild-to-moderate, or moderate CTS. The patients were randomized into two groups using random number table. In the first group, (Group 1)( n = 35), patients were given splint (every night for 6 weeks) + peloid treatment(five consecutive days a week for 2 weeks) and in the second group, (Group 2)( n = 28), patients received splint treatment(every night for 6 weeks) alone. The patients were assessed by using visual analog scale(VAS) for pain, electroneuromyography(ENMG), the Boston Carpal Tunnel Syndrome Questionnaire(BCTSQ), hand grip strength(HGS), finger grip strength(FGS), and Short Form-12(SF-12). The data were obtained before treatment(W0), immediately after treatment(W2), and one month after treatment(W6). Both in Group 1 and 2, there was a statistically significant improvement in all the evaluation parameters at W2 and W6 when compared to W0( p < 0.05). Comparison of the groups with each other revealed significantly better results for VAS, BCTSQ, mSNCV, SF-12 in Group 1 than in Group 2 at W2( p < 0.05). There was also a statistically significant difference in favor of Group 1 for VAS, BCTSQ, FGS and MCS at W6 when compared to W0 ( p < 0.05). The results of our study demonstrated that in patients with CTS; peloid + splint treatment was more effective than splint treatment alone in pain, functionality and life quality both at after treatment(W2) and one month after treatment (W6). We may suggest peloid as a supplementary therapeutic agent in CTS. [ABSTRACT FROM AUTHOR]

Giriş: En sık görülen tuzak nöropati olan karpal tünel sendromu elektronöromiyografi (ENMG) sonuçlarının retrospektif taranarak sonuçların irdelenmesi amaçlanmıştır. Materyal ve Metod: 24 aylık süreçte EMG laboaratuarına Karpal Tünel Sendrom (KTS) ön tanısı ile başvuran 1196 hasta çalışmaya alınmıştır. Bulgular: Elektrofizyolojik inceleme sonucunda 520 (%43,5) olgu normal olarak değerlendirilirken, 676 (%56,5)"sında karpal tünel sendromunu destekler bulgular (n:296- hafif, n:285-orta ve n:95- ağır düzeyde) saptanmıştır. Sonuç: KTS ön tanısı ile elektrofizyoloji laboratuarına refere edilen olguların % 43,5"ünde normal elektrofizyolojik bulgular elde edilmesi hastalara yeterli süre ayrılarak daha dikkatli klinik değerlendirme yapmanın önemini ortaya koymaktadır.

Purpose: It was planned to document the results of our clinic electroneuromyography (ENMG) examination at the most frequently observed entrapment neuropathy . Material and Method: In the last 24 months, who applied to ENMG laboratory of Harran University Faculty of Medicine, 1196 patients with an initial diagnosis of Carpal Tunnel Syndrome (CTS) were included in the study retrospectively. Results: The result of the electrophysiological examination 520 (43.5%) cases were reported as normal. 676 (56.5%) patients (296 light and 285 medium and 95 severe) were determined of CTS by electrophysiological examination. Discussion: Normally result in a rate of 43.5% of initial diagnosis of the CTS by EMG, demonstrates the importance of sufficient time and more careful clinical assessment. However, EMG maintains its position the diagnosis of CTS and similar clinical situations, treatment and assessment of prognosis. [Cukurova Med J 2013; 38(2.000): 209-213]

There has been few reports on electroneuromyography (ENMG) changes in hypothyroidism. The objectives of the present study were to investigate the frequency of ENMG abnormalities in hypothyroidism and correlate them with neurological signs and symptoms and muscle enzyme levels; and to compare latency, amplitude and nerve conduction velocity from selected nerves with controls. Sixteen patients suffering from primary hypothyroidism were submitted to ENMG before treatment. ENMG abnormalities were found in 87.5% of the patients; 46.6% had myopathy and 43.7% had carpal tunnel syndrome. There was no case of polyneuropathy. A clear-cut clinical, laboratorial and ENMG correlation was observed in patients with myopathy and carpal tunnel syndrome. The patients showed a significant tendency of nerve conduction slowness as compared with controls. The findings are in accordance with the well-known nerve and muscle damage in hypothyroidism.Foram avaliados através de eletroneuromiografia (ENMG) 16 pacientes com hipotireoidismo primário de diversas etiologias, virgens de tratamento, com o objetivo de: estabelecer a incidência de alterações; correlacioná-las com parâmetros clínicos referentes ao acometimento do sistema nervoso periférico e níveis de enzimas musculares; estabelecer a comparação entre valores médios da latência, amplitude e velocidade de condução nervosa de alguns nervos selecionados no grupo de pacientes e de grupo controle. Alterações da ENMG foram encontradas em 87,5% dos casos, sendo estabelecido diagnóstico eletrofisiológico de miopatia em 46,6% e de síndrome do túnel do carpo em 43,7%. Nenhum dos casos foi identificado como polineuropatia. A concordância entre sintomatologia (100%), exame neurológico (28,57%), níveis de enzimas musculares (42,85%) e ENMG foi elevada para casos de miopatia. Nos casos de síndrome do canal carpiano foi respectivamente de 71,42% para sintomatologia e 71,42% para exame neurológico. A comparação de valores médios dos parâmetros selecionados de neurocondução, entre pacientes e controle, demonstrou tendência generalizada à lentificação da condução nervosa no hipotireoidismo primário. A literatura revista concorda com os dados dos autores em relação à extensão do dano de nervo e músculo nessa endocrinopatia.

Investigation of consistency between clinical referral diagnosis and Electroneuromyographic (ENMG) diagnosis was aimed in this study. Reports of ENMG results were analyzed retrospectively. Reports were classified according to clinical referral diagnosis and ENMG diagnosis. Data of patients' name, age, gender, clinical referral diagnosis, and ENMG diagnosis were present in reports. ENMG reports of 820 patients (225, 27.4% male; 595, 72.6%, female) with the mean age of 46.8±10.5 (17-81) years were analyzed. Clinical referral diagnosis were indicated in all of the reports. Clinical referral diagnosis were detected in 535 (65.3%) reports as carpal tunnel syndrome, in 114 (13.9%) reports as peripheral nevre injury, in 78 (9.5%) reports as unlar nevre entrapment neuropathy, in 68 (8.3%) reports as polyneuropathy, in 25 (3%) reports as radiculopathy. 327 (39.8%) of ENMG tests were reported as normal results. The most frequent diagnosis according to ENMG was carpal tunnel syndrome (n=313, 38.1%), following respectively other diagnosises were peripheral nerve injury (n=101, 12.3%), ulnar entrapment neuropathy (n=41, 5%), polyneuropathy (n=32, 3.9%), and radiculopathy (n=7, 0.9%). Consistency between clinical referral diagnosis and ENMG diagnosis for carpal tunnel syndrome was 56.1%, for ulnar entrapment neuropathy was 50%, for peripheral nerve injury was 86.8%, for polyneuropathy was 36.8% for radiculopathy was 28%. Detailed clinical examination of patients before ENMG test, and to inform the physician who will execute the ENMG test about the findings of physical examination and clinical referral diagnosis can provide effective use of ENMG. [ABSTRACT FROM AUTHOR]