The effect of external pressure on nerve conduction in median nerve of healthy individuals and clinically diagnosed patients of carpal tunnel syndrome
Journal Title: Medpulse International Journal of Physiology - Year 2018, Vol 8, Issue 2
Abstract
This study examines the evidence for the ill effects of external pressure on nerve conduction in median nerve and it’s after effects in Carpal Tunnel patients comparing to normal subject. Present work is undertaken to study the electrophysiological changes happening to the already compressed nerve when it is subjected to external compression using pneumatic tourniquet. With the help of it we are evaluating the extent of damage and deterioration occurring in median nerve of CTS affected patients compared to healthy individuals and there by trying to find out whether the median nerve of these patients are more susceptible to external compression as in the surgical use of tourniquet. This study may help for the better management of tourniquet, to determine the safe duration and pressure for CTS patients especially in surgeries for compression neuropathies and to reduce surgical failures due to it. Methodology: Electro-diagnostic studies were conducted on sixty healthy individuals and sixty Carpal Tunnel Syndrome patients which includes Motor and Sensory conduction of Median nerve on the right hand of the subjects and the patients. It is studied before application of pressure, after 15 minutes of 150 mm of Hg pressure application and after 15 min of rest on releasing the pressure. Results: In patients of CTS, significant difference was observed between before application of pressure and after 15 min of rest on releasing pressure in Motor conduction parameters such as a) Motor conduction velocity b) Amplitude of CMAP and c) Distant motor latency. There was very significant difference in all sensory parameters such as a) Sensory Conduction Velocity [SCV], b) Amplitude of SNAP and c) Distal Sensory Latency [DSL] between the initial reading and after 15 min of rest on release of pressure in CTS patients, where in controls this difference was not seen. Which suggests that, the fall in Sensory parameters after pressure was restored to normal level after 15 min of rest in controls, this change was not seen in patients since the changes occurred due to application of pressure was not reverting back. Conclusion: All these results indicates that the vascular changes due to external pressure causes a sustained ill effect on the median nerve of CTS patients comparing to the controls. In CTS Patients because of the ischemia and venous congestion the deterioration of nerve takes a more grievous course which is also rapid. Key Word: Carpal tunnel syndrome, Median Nerve, Nerve conduction
Authors and Affiliations
Ribu Sam Stephen, A G Joshi, Basheer MP
Keywords
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