Median to ulnar nerve comparison on diagnosis of carpal tunnel syndrome in patients with diabetic polyneuropathy : A neurophysiological study = A nervus medianus és a nervus ulnaris összehasonlítása a carpalis alagút szindróma diagnosztikájában diabeteses polineuropathiás betegeknél – neurofiziológiai vizsgálat

• Published in: Ideggyógyászati szemle
• Main Author: Alemdar, Murat
• Format: Article in Journal/Newspaper
• Language: English
• Published: LifeTime Media Kft. 2023
• Subjects: RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry / idegkórtan; neurológia; pszichiátria; DML
• Online Access: https://real.mtak.hu/170538/; https://real.mtak.hu/170538/1/a-nervus-medianus-es-a-nervus-ulnaris-osszehasonlitasa-a-carpalis-alagut-szindroma-diagnosztikajaban-diabeteses-polineuropathias-betegeknel-neurofiziologiai-vizsgalat.pdf; https://doi.org/10.18071/isz.76.0115

Background and purpose – To analyze the utility of median nerve (MN) to ulnar nerve (UN) comparative parameters on the diagnosis of carpal tunnel syndrome (CTS) in diabetic patients with distal symmetrical sensorimotor polyneuropathy (DSMPNP). Methods – Patients who were referred to our electroneuromyography laboratory within the last two years were included. We compared the diagnostic accuracy values of traditional MN conduction parameters, and the MN-to-UN comparative tests on electro- diagnosis of CTS between the patients with DSMPNP involving the nerves of upper and lower extremities (UEI-positive group), and the ones without the involvement of upper extremities (UEI-negative group). Results – There were 64 upper extremities in the UEI-positive group and 70 patients in the UEI-negative group. The most accurate traditional parameter was MN distal motor latency (DML) with a diagnostic accuracy of 70.2% whereas the most accurate compara- tive technique was the second lumbrical- interosseous DML difference (2L-INT DMLD) with an accuracy of 81.3%. (p=0.03). In ad- dition, when compared diagnostic accuracy values of MN parameters with their cor- responding comparative parameters in the UEI-positive group which carries the major diagnostic challenges for detecting co-mor- bid CTS, MN to UN minimum F wave latency (mFWL) difference, SNAP amplitude ratio on the ring finger (RF), and 2L-INT DMLD had higher accuracy values than MN mFWL, MN SNAP amplitude on RF, and MN DML on lumbrical muscle, respectively (p<0.05 for all comparisons). Conclusion – MN to UN comparative stu- dies have high accuracy values in electro- diagnosis of CTS in DSMPNP. In particular, 2L-INT DMLD could be helpful to overcome the diagnostic difficulty in the presence of UEI as an additional conduction technique. | Háttér és cél – Annak elemzése, hogy meny- nyire hasznos a nervus medianus (MN) és a nervus ulnaris (UN) paramétereinek összeha- sonlítása distalis szimmetrikus szenzomoto- ros polyneuropathiában (DSMPNP) szenvedő diabeteses betegek ...