Evaluation Of The Compound Muscle Action Potential In Diagnosis Of The Mild Carpal Tunnel Syndrome

• Published in: International Journal of Applied Mathematics, Electronics and Computers
• Main Authors: Alcan, Veysel, Zinnuroğlu, Murat, Kaymak Karataş, Gülçin, Canal, Mehmet Rahmi
• Format: Article in Journal/Newspaper
• Language: unknown
• Published: Selcuk University 2016
• Subjects: carpal tunnel syndrome,motor nerve conduction study,signal processing; DML
• Online Access: https://dergipark.org.tr/tr/pub/ijamec/issue/25619/280468; https://doi.org/10.18100/ijamec.280468

Carpal tunnel syndrome (CTS) is the most common entrapmentneuropathy. In most patients, the diagnosis can be proposed based on patienthistory and clinical symptoms, with electrophysical findings. The mild CTS maynot produce any nerve conduction abnormalities and this can make standardconventional tests not enough in diagnosis the mild CTS. The aim of this studywas to evaluate Compound Muscle Action Potential (CMAP) morphology as more sensitiveand specific parameters without any additional testing for diagnosis the mildCTS. A total of seventy seven clinically diagnosed patients with CTS wereprospectively enrolled. Data was evaluated from seventy normal hands and fortysix hands with the diagnosis of the mild CTS with standard electrodiagnostic(EDX) tests and clinical findings. The specificity and sensitivity rate werecalculated to evaluate the utility of CMAP negative peak (NP) morphologyparameters evaluated duration (CMAP NPHalf-Duration and CMAP NPFull-Duration)and area (CMAP NPHalf-Area and CMAP NPFull-Area) bycomparing the standard EDX test (Median Distal Motor Latency (DML) and peak topeak amplitude of CMAP (CMAP NPAmplitude) recorded from the abductorpolicies brevis (APB) muscle. Although CMAP NPHalf-Duration and CMAPNPFull-Duration had no statistically significantly differencebetween the mild CTS and normal group (p>0.05), DML, CMAP NPAmplitude,CMAP NPHalf-Area and CMAP NPFull-Area in the mild CTSgroup were statistically significantly different (p<0.05). The present studyshown CMAP NPFull-Area had the highest sensitivity and moderatespecificity rate (90.0% and 42.2%, respectively). Furthermore, it was confirmedagain that DML was a valuable motor nerve conduction technique for thediagnosis of the mild CTS with high sensitivity and moderate specificity (84.8%and 47.6%, respectively), and it had more sensitive than CMAP NPHalf-Area highsensitivity and moderate specificity (80.0% and 38.7%, respectively).This studyprovided the evidence of CMAP NPFull-Area and CMAP NPHalf-Area thatcould be predictors of the mild CTS