Lumbrical-interosseous latency comparison test as a highly sensitive tool in diagnosing mild and severe carpal tunnel syndrome
Journal Title: Family Medicine & Primary Care Review - Year 2015, Vol 17, Issue 4
Abstract
Background. The diagnosis of the very early and very advanced stages of carpal tunnel syndrome (CTS) is still challenging. Objectives. We evaluated whether a nerve conduction study measuring the difference in latencies between the second lumbrical and dorsal interosseous muscles (2LI-DML) is useful for diagnosing mild and severe CTS. Material and methods. The study included 25 patients (25 hands) clinically diagnosed with severe CTS and 42 patients (51 hands) with mild CTS. The control group consisted of 60 healthy volunteers. A total of 172 patients (253 hands) gave their consent to participate in the study. The main outcome measures were the percentage of clinical diagnoses of mild and severe CTS, confirmed using a standard electrophysiological method (the sensory nerve conduction study from at least one median innervated digit and the difference between median and ulnar sensory latencies [D4M-D4U]) and the percentage of clinical diagnoses of mild and severe CTS confirmed with the 2LI-DML test as an alternative lectrophysiological method. Results. In patients with mild CTS, 2LI-DML and D4M-D4U were increased in 90% and 67% of the hands, respectively. Antidromic sensory nerve conduction from the wrist to digits 1, 3, and 4 was abnormal in 57%, 45%, and 47% of the hands,respectively. In patients with severe CTS, 2LI-DML was abnormal in 96% of the patients. In 4% of the patients (1 hand), the response could not be obtained. Conclusions. Our findings suggest that the 2LI-DML test is a sensitive and useful method for diagnosing CTS, regardless of its severity.
Authors and Affiliations
Marta Banach, Antoni Ferens, Jakub Antczak, Dorota Gribbin
Keywords
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