Sensory distribution indicates severity of median nerve damage in carpal tunnel syndrome

Abstract Objective Sensory symptoms within the median nerve distribution are a primary clinical diagnostic criterion for the diagnosis of carpal tunnel syndrome (CTS). However, the distribution of the sensory symptoms in CTS varies from patient to patient. This study identifies the clinical and elec...

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Veröffentlicht in:Clinical neurophysiology 2008-07, Vol.119 (7), p.1619-1625
Hauptverfasser: Wilder-Smith, E.P, Ng, E.S, Chan, Y.H, Therimadasamy, A.K
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container_end_page 1625
container_issue 7
container_start_page 1619
container_title Clinical neurophysiology
container_volume 119
creator Wilder-Smith, E.P
Ng, E.S
Chan, Y.H
Therimadasamy, A.K
description Abstract Objective Sensory symptoms within the median nerve distribution are a primary clinical diagnostic criterion for the diagnosis of carpal tunnel syndrome (CTS). However, the distribution of the sensory symptoms in CTS varies from patient to patient. This study identifies the clinical and electrophysiological findings that correlate with the distribution of sensory symptoms in an Asian population with CTS. Methods In a prospective study of 105 patients with electrophysiologically confirmed CTS, clinical and educational data were correlated with sensory symptom distribution. Results Median nerve distribution was strongly associated with more severe nerve conduction abnormality, male gender, and relief by movement. Patients with a complete median sensory distribution had more electrophysiological abnormality than those with an incomplete median distribution. Extra-median distribution was associated with the least nerve conduction abnormality. Educational qualification, age, symptom duration and body mass index were not associated with the pattern of sensory symptoms. Conclusions In carpal tunnel syndrome, sensory symptom distribution is strongly dependant on the degree of electrophysiological median nerve damage. Median nerve sensory distribution is associated with severe nerve damage. Significance This study provides clinicians with a simple clinical rule for assigning the degree of median nerve damage in patients with CTS based on sensory distribution patterns.
doi_str_mv 10.1016/j.clinph.2008.03.022
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However, the distribution of the sensory symptoms in CTS varies from patient to patient. This study identifies the clinical and electrophysiological findings that correlate with the distribution of sensory symptoms in an Asian population with CTS. Methods In a prospective study of 105 patients with electrophysiologically confirmed CTS, clinical and educational data were correlated with sensory symptom distribution. Results Median nerve distribution was strongly associated with more severe nerve conduction abnormality, male gender, and relief by movement. Patients with a complete median sensory distribution had more electrophysiological abnormality than those with an incomplete median distribution. Extra-median distribution was associated with the least nerve conduction abnormality. Educational qualification, age, symptom duration and body mass index were not associated with the pattern of sensory symptoms. Conclusions In carpal tunnel syndrome, sensory symptom distribution is strongly dependant on the degree of electrophysiological median nerve damage. Median nerve sensory distribution is associated with severe nerve damage. Significance This study provides clinicians with a simple clinical rule for assigning the degree of median nerve damage in patients with CTS based on sensory distribution patterns.</description><identifier>ISSN: 1388-2457</identifier><identifier>EISSN: 1872-8952</identifier><identifier>DOI: 10.1016/j.clinph.2008.03.022</identifier><identifier>PMID: 18467170</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aging - physiology ; Analysis of Variance ; Asian Continental Ancestry Group ; Biological and medical sciences ; Body Mass Index ; Carpal tunnel syndrome ; Carpal Tunnel Syndrome - pathology ; Clinical neurology ; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction ; Education ; Electrodiagnosis ; Electrodiagnosis. Electric activity recording ; Electrophysiology ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Median nerve ; Median Nerve - pathology ; Medical sciences ; Middle Aged ; Motor Neurons - physiology ; Nerve conduction ; Nervous system ; Nervous system (semeiology, syndromes) ; Neural Conduction - physiology ; Neurology ; Neurons, Afferent - physiology ; Prospective Studies ; Sensation - physiology ; Sensory distribution</subject><ispartof>Clinical neurophysiology, 2008-07, Vol.119 (7), p.1619-1625</ispartof><rights>International Federation of Clinical Neurophysiology</rights><rights>2008 International Federation of Clinical Neurophysiology</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-f0598f2d9184e66d7ec90578269b98da54ecf51e96272325697a4622e1e0fcf73</citedby><cites>FETCH-LOGICAL-c445t-f0598f2d9184e66d7ec90578269b98da54ecf51e96272325697a4622e1e0fcf73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clinph.2008.03.022$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3538,27906,27907,45977</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20470437$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18467170$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilder-Smith, E.P</creatorcontrib><creatorcontrib>Ng, E.S</creatorcontrib><creatorcontrib>Chan, Y.H</creatorcontrib><creatorcontrib>Therimadasamy, A.K</creatorcontrib><title>Sensory distribution indicates severity of median nerve damage in carpal tunnel syndrome</title><title>Clinical neurophysiology</title><addtitle>Clin Neurophysiol</addtitle><description>Abstract Objective Sensory symptoms within the median nerve distribution are a primary clinical diagnostic criterion for the diagnosis of carpal tunnel syndrome (CTS). However, the distribution of the sensory symptoms in CTS varies from patient to patient. This study identifies the clinical and electrophysiological findings that correlate with the distribution of sensory symptoms in an Asian population with CTS. Methods In a prospective study of 105 patients with electrophysiologically confirmed CTS, clinical and educational data were correlated with sensory symptom distribution. Results Median nerve distribution was strongly associated with more severe nerve conduction abnormality, male gender, and relief by movement. Patients with a complete median sensory distribution had more electrophysiological abnormality than those with an incomplete median distribution. Extra-median distribution was associated with the least nerve conduction abnormality. Educational qualification, age, symptom duration and body mass index were not associated with the pattern of sensory symptoms. Conclusions In carpal tunnel syndrome, sensory symptom distribution is strongly dependant on the degree of electrophysiological median nerve damage. Median nerve sensory distribution is associated with severe nerve damage. Significance This study provides clinicians with a simple clinical rule for assigning the degree of median nerve damage in patients with CTS based on sensory distribution patterns.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - physiology</subject><subject>Analysis of Variance</subject><subject>Asian Continental Ancestry Group</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Carpal tunnel syndrome</subject><subject>Carpal Tunnel Syndrome - pathology</subject><subject>Clinical neurology</subject><subject>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</subject><subject>Education</subject><subject>Electrodiagnosis</subject><subject>Electrodiagnosis. Electric activity recording</subject><subject>Electrophysiology</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Median nerve</subject><subject>Median Nerve - pathology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Motor Neurons - physiology</subject><subject>Nerve conduction</subject><subject>Nervous system</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neural Conduction - physiology</subject><subject>Neurology</subject><subject>Neurons, Afferent - physiology</subject><subject>Prospective Studies</subject><subject>Sensation - physiology</subject><subject>Sensory distribution</subject><issn>1388-2457</issn><issn>1872-8952</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGL1TAUhYsozjj6D0Sy0V3rzW3apBtBBmcUBmYxCu5CXnqrebbJM2kf9N-b8h4KbmaVLL57OHynKF5zqDjw9v2-sqPzh58VAqgK6goQnxSXXEksVdfg0_yvlSpRNPKieJHSHgAkCHxeXHAlWsklXBbfH8inEFfWuzRHt1tmFzxzvnfWzJRYoiNFN68sDGyi3hnPPMUjsd5M5gdlklkTD2Zk8-I9jSytvo9hopfFs8GMiV6d36vi282nr9efy7v72y_XH-9KK0QzlwM0nRqw73Ilatteku2gkQrbbtep3jSC7NBw6lqUWGPTdtKIFpE4wWAHWV8V7065hxh-L5RmPblkaRyNp7Ak3XbIAUWdQXECbQwpRRr0IbrJxFVz0JtRvdcno3ozqqHW2Wg-e3POX3ZZwL-js8IMvD0DJlkzDtF469JfDkFk6fVW9MOJo2zj6CjqZB15m6VGsrPug3usyf8BG5R3Gn_RSmkfluizac11Qg36YVt_Gx8UAIKq6z9wpKtV</recordid><startdate>20080701</startdate><enddate>20080701</enddate><creator>Wilder-Smith, E.P</creator><creator>Ng, E.S</creator><creator>Chan, Y.H</creator><creator>Therimadasamy, A.K</creator><general>Elsevier Ireland Ltd</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080701</creationdate><title>Sensory distribution indicates severity of median nerve damage in carpal tunnel syndrome</title><author>Wilder-Smith, E.P ; Ng, E.S ; Chan, Y.H ; Therimadasamy, A.K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-f0598f2d9184e66d7ec90578269b98da54ecf51e96272325697a4622e1e0fcf73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - physiology</topic><topic>Analysis of Variance</topic><topic>Asian Continental Ancestry Group</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Carpal tunnel syndrome</topic><topic>Carpal Tunnel Syndrome - pathology</topic><topic>Clinical neurology</topic><topic>Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction</topic><topic>Education</topic><topic>Electrodiagnosis</topic><topic>Electrodiagnosis. Electric activity recording</topic><topic>Electrophysiology</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Median nerve</topic><topic>Median Nerve - pathology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Motor Neurons - physiology</topic><topic>Nerve conduction</topic><topic>Nervous system</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neural Conduction - physiology</topic><topic>Neurology</topic><topic>Neurons, Afferent - physiology</topic><topic>Prospective Studies</topic><topic>Sensation - physiology</topic><topic>Sensory distribution</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilder-Smith, E.P</creatorcontrib><creatorcontrib>Ng, E.S</creatorcontrib><creatorcontrib>Chan, Y.H</creatorcontrib><creatorcontrib>Therimadasamy, A.K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neurophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilder-Smith, E.P</au><au>Ng, E.S</au><au>Chan, Y.H</au><au>Therimadasamy, A.K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sensory distribution indicates severity of median nerve damage in carpal tunnel syndrome</atitle><jtitle>Clinical neurophysiology</jtitle><addtitle>Clin Neurophysiol</addtitle><date>2008-07-01</date><risdate>2008</risdate><volume>119</volume><issue>7</issue><spage>1619</spage><epage>1625</epage><pages>1619-1625</pages><issn>1388-2457</issn><eissn>1872-8952</eissn><abstract>Abstract Objective Sensory symptoms within the median nerve distribution are a primary clinical diagnostic criterion for the diagnosis of carpal tunnel syndrome (CTS). However, the distribution of the sensory symptoms in CTS varies from patient to patient. This study identifies the clinical and electrophysiological findings that correlate with the distribution of sensory symptoms in an Asian population with CTS. Methods In a prospective study of 105 patients with electrophysiologically confirmed CTS, clinical and educational data were correlated with sensory symptom distribution. Results Median nerve distribution was strongly associated with more severe nerve conduction abnormality, male gender, and relief by movement. Patients with a complete median sensory distribution had more electrophysiological abnormality than those with an incomplete median distribution. Extra-median distribution was associated with the least nerve conduction abnormality. Educational qualification, age, symptom duration and body mass index were not associated with the pattern of sensory symptoms. Conclusions In carpal tunnel syndrome, sensory symptom distribution is strongly dependant on the degree of electrophysiological median nerve damage. Median nerve sensory distribution is associated with severe nerve damage. Significance This study provides clinicians with a simple clinical rule for assigning the degree of median nerve damage in patients with CTS based on sensory distribution patterns.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>18467170</pmid><doi>10.1016/j.clinph.2008.03.022</doi><tpages>7</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Aging - physiology
Analysis of Variance
Asian Continental Ancestry Group
Biological and medical sciences
Body Mass Index
Carpal tunnel syndrome
Carpal Tunnel Syndrome - pathology
Clinical neurology
Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction
Education
Electrodiagnosis
Electrodiagnosis. Electric activity recording
Electrophysiology
Female
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Median nerve
Median Nerve - pathology
Medical sciences
Middle Aged
Motor Neurons - physiology
Nerve conduction
Nervous system
Nervous system (semeiology, syndromes)
Neural Conduction - physiology
Neurology
Neurons, Afferent - physiology
Prospective Studies
Sensation - physiology
Sensory distribution
title Sensory distribution indicates severity of median nerve damage in carpal tunnel syndrome
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