Arquivos de Neuro-Psiquiatria
On-line version ISSN 1678-4227
HARDOIM, Dante Guilherme Velasco; OLIVEIRA, Guilherme Bueno de and KOUYOUMDJIAN, João Aris. Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands. Arq. Neuro-Psiquiatr. [online]. 2009, vol.67, n.1, pp. 69-73. ISSN 1678-4227. http://dx.doi.org/10.1590/S0004-282X2009000100017.
OBJECTIVE: To compare a long-term carpal tunnel syndrome (CTS) on nerve conduction studies (NCS) in hands treated non-surgically. METHOD: We retrospectively selected 261 symptomatic CTS hands (166 patients), all of them confirmed by NCS. In all cases, at least 2 NCS were performed in an interval greater than 12 months. Cases with associated polyneuropathy were excluded. NCS parameters for CTS electrodiagnosis included a sensory conduction velocity (SCV) <46.6 m/s (wrist to index finger, 14 cm) and distal motor latency (DML) >4.25 ms (wrist to APB, 8 cm). RESULTS: 92.8% were women; mean age was 49 years (20-76); the mean interval between NCS was 47 months (12-150). In the first exam, the median sensory nerve action potential (SNAP) and the compound action muscular potential were absent in 9.8% and 1.9%, respectively. In the second/last exam, SCV worsened in 54.2%, remained unchanged in 11.6% and improved in 34.2%. SNAP amplitude worsened in 57.7%, remained unchanged in 13.1% and improved in 29.2%. DML worsened in 52.9%, remained unchanged in 7.6% and improved in 39.5%. Overall, NCS parameters worsened in 54.9%, improved in 34.3% and remained unchanged in 10.8%. CONCLUSION: Long-term changing in NCS of CTS hands apparently were not related to clinical symptomatology and could lead to some difficulty in clinical correlation and prognosis. Aging, male gender and absent SNAP were more related to NCS worsening, regardless the mean interval time between the NCS.
Keywords : carpal tunnel syndrome; median nerve; nerve conduction studies; compressive neuropathy; long-term electrophysiological evaluation.