When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome?
OBJECTIVES: This study aims to evaluate the predictors of standard nerve conduction study (NCS) parameters in determining the presence of axonal loss by means of spontaneous activity in patients with mild and moderate carpal tunnel syndrome (CTS). PATIENTS AND METHODS: Between May 2015 and April 201...
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ftpubmed:oai:pubmedcentral.nih.gov:8790263 2023-05-15T16:01:25+02:00 When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? Özişler, Zuhal Akyüz, Müfit 2021-12-01 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790263/ http://www.ncbi.nlm.nih.gov/pubmed/35141492 https://doi.org/10.5606/tftrd.2021.8555 en eng Bayçınar Medical Publishing http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790263/ http://www.ncbi.nlm.nih.gov/pubmed/35141492 http://dx.doi.org/10.5606/tftrd.2021.8555 Copyright © 2021, Turkish Society of Physical Medicine and Rehabilitation https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. CC-BY-NC Turk J Phys Med Rehabil Original Article Text 2021 ftpubmed https://doi.org/10.5606/tftrd.2021.8555 2022-02-13T01:29:25Z OBJECTIVES: This study aims to evaluate the predictors of standard nerve conduction study (NCS) parameters in determining the presence of axonal loss by means of spontaneous activity in patients with mild and moderate carpal tunnel syndrome (CTS). PATIENTS AND METHODS: Between May 2015 and April 2018, a total of 118 patients (11 males, 107 females; mean age: 52.3±10.6 years; range, 27 to 79 years) who underwent electrophysiological studies and were diagnosed with CTS were included. Demographic data of the patients including age, sex, and symptom duration were recorded. Electrodiagnostic studies were performed in all patients. All the needle electromyography (EMG) findings were recorded, but only the presence or absence of spontaneous EMG activities was used as the indicator of axonal injury. RESULTS: In 37 (31.4%) of the patients, spontaneous activity was detected at the thenar muscle needle EMG. No spontaneous activity was observed in any of 43 (36.4%) patients with normal distal motor latency (DML). There were significant differences in DMLs, compound muscle action potential (CMAP) amplitudes, sensory nerve action potentials amplitudes, and sensory nerve conduction velocities between the groups with and without spontaneous activity (p<0.05). The multiple logistic regression analysis revealed that DML was a significant independent risk variable in determining presence of spontaneous activity. The most optimal cut-off value for median DML was calculated as 4.9 ms. If the median DML was >4.9 ms, the relative risk of finding spontaneous activity on thenar muscle needle EMG was 13.5 (95% CI: 3.6-51.2). CONCLUSION: Distal motor latency is the main parameter for predicting the presence of spontaneous activity in mild and moderate CTS patients with normal CMAP. Performing needle EMG of the thenar muscle in CTS patients with a DML of >4.9 ms may be beneficial to detect axonal degeneration in early stages. Text DML PubMed Central (PMC) The Needle ENVELOPE(-64.047,-64.047,63.267,63.267) Turkish Journal of Physical Medicine and Rehabilitation 67 4 518 525 |
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Original Article Özişler, Zuhal Akyüz, Müfit When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
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Original Article |
description |
OBJECTIVES: This study aims to evaluate the predictors of standard nerve conduction study (NCS) parameters in determining the presence of axonal loss by means of spontaneous activity in patients with mild and moderate carpal tunnel syndrome (CTS). PATIENTS AND METHODS: Between May 2015 and April 2018, a total of 118 patients (11 males, 107 females; mean age: 52.3±10.6 years; range, 27 to 79 years) who underwent electrophysiological studies and were diagnosed with CTS were included. Demographic data of the patients including age, sex, and symptom duration were recorded. Electrodiagnostic studies were performed in all patients. All the needle electromyography (EMG) findings were recorded, but only the presence or absence of spontaneous EMG activities was used as the indicator of axonal injury. RESULTS: In 37 (31.4%) of the patients, spontaneous activity was detected at the thenar muscle needle EMG. No spontaneous activity was observed in any of 43 (36.4%) patients with normal distal motor latency (DML). There were significant differences in DMLs, compound muscle action potential (CMAP) amplitudes, sensory nerve action potentials amplitudes, and sensory nerve conduction velocities between the groups with and without spontaneous activity (p<0.05). The multiple logistic regression analysis revealed that DML was a significant independent risk variable in determining presence of spontaneous activity. The most optimal cut-off value for median DML was calculated as 4.9 ms. If the median DML was >4.9 ms, the relative risk of finding spontaneous activity on thenar muscle needle EMG was 13.5 (95% CI: 3.6-51.2). CONCLUSION: Distal motor latency is the main parameter for predicting the presence of spontaneous activity in mild and moderate CTS patients with normal CMAP. Performing needle EMG of the thenar muscle in CTS patients with a DML of >4.9 ms may be beneficial to detect axonal degeneration in early stages. |
format |
Text |
author |
Özişler, Zuhal Akyüz, Müfit |
author_facet |
Özişler, Zuhal Akyüz, Müfit |
author_sort |
Özişler, Zuhal |
title |
When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
title_short |
When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
title_full |
When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
title_fullStr |
When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
title_full_unstemmed |
When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
title_sort |
when is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome? |
publisher |
Bayçınar Medical Publishing |
publishDate |
2021 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790263/ http://www.ncbi.nlm.nih.gov/pubmed/35141492 https://doi.org/10.5606/tftrd.2021.8555 |
long_lat |
ENVELOPE(-64.047,-64.047,63.267,63.267) |
geographic |
The Needle |
geographic_facet |
The Needle |
genre |
DML |
genre_facet |
DML |
op_source |
Turk J Phys Med Rehabil |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790263/ http://www.ncbi.nlm.nih.gov/pubmed/35141492 http://dx.doi.org/10.5606/tftrd.2021.8555 |
op_rights |
Copyright © 2021, Turkish Society of Physical Medicine and Rehabilitation https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
op_rightsnorm |
CC-BY-NC |
op_doi |
https://doi.org/10.5606/tftrd.2021.8555 |
container_title |
Turkish Journal of Physical Medicine and Rehabilitation |
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67 |
container_issue |
4 |
container_start_page |
518 |
op_container_end_page |
525 |
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1766397289188818944 |