ABSTRACT
BACKGROUND: Carpal tunnel syndrome (CTS) is the commonest median nerve entrapment neuropathy, with preponderance in females. AIMS AND OBJECTIVE: The aim of the present study was to find out wrist ratio (WR) and wrist/palm ratio (WPR) in clinically diagnosed patients of CTS. METHODOLOGY: One hundred individuals (fifty patients of CTS and fifty as control group) aged between 30 and 50 years were recruited for the study. Early confirmation of clinically suspected patients of CTS was done by performing electrodiagnostic tests of median and ulnar nerves. Motor and sensory conduction velocities, distal motor and sensory latencies, and F-wave latencies were performed in the recruited volunteers. RESULTS: The values for mean wrist ratio in control groups were 0.694, 0.703 respectively, and in patients with carpal tunnel syndrome, it was 0.704 and 0.719 respectively in moderate and severe type. The mean wrist to palm ratio (WPR) in control group was 0.371, while in patients with CTS, it was 0.374, 0.382, 0.387, and 0.401 based on progression of severity. Both were statistically significant for the last two groups (wrist to index finger [WIF] >4.4 m/s, moderate, and WIF nonrecordable, severe). Statistically significant (P < 0.001) decrease of motor conduction velocities for median nerve was seen in the CTS group as compared to control group. Statistically significant (P < 0.001) increase in distal motor and sensory latencies was observed for both median and ulnar nerves in CTS group with more increase in distal motor latency than sensory latency. Increase in F-wave latencies of both nerves was seen in CTS group. CONCLUSION: The study results confirm selective slowing of sensory and motor conduction within wrist-to-palm segment in patients of CTS. Both WR and WPR have a progressive correlation with the severity of CTS, but statistically significant changes were seen in the groups with moderate and severe CTS. Thus, WR/WPR can act as one of the essential parameters in the diagnosis of CTS with moderate-to-severe CTS.
ABSTRACT
BACKGROUND: Nerve conduction studies are performed to diagnose the disorders of the peripheral nervous system. The reference values for nerve conduction velocity (NCV) and late responses for different nerves considerably vary in different group and type of population. Physiological factors such as age, temperature, height, and gender affect the NCV. However, there are very few studies which show the age group at which these changes become significant. AIM AND OBJECTIVES: The aim of the study was to establish the electrophysiological data of the specific age group at which changes in NCV as well as late responses of median common peroneal nerve and also see the late response in the form of F-waves and H-reflex. METHODOLOGY: Study groups were divided into three categories based on the age: Group I (18-30 years) (n = 80), Group II (31-45 years) (n = 43), and Group III (46-60 years) (n = 27). Out of which, 93 patients were male and 57 were female. The NCVs were determined for median, common peroneal nerve (motor component and sensory component) along with late responses in the form of H-reflex and F-waves. RESULTS: The mean and standard deviation of median, ulnar, peroneal, and tibial nerve was studied for latencies, amplitude, and velocities for both sensory and motor components. Patients with older age had longer latencies, smaller amplitudes, and slower conduction velocities compared with the younger age group. The change with age was greater in sensory nerve conduction and late responses in all the peripheral nerves. CONCLUSIONS: Aging has a definite correlation with the NCV and late responses of different peripheral nerves. There is a need to have reference values with relation to age.