SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME

Eroğlu, Selma; Bodur, Hatice; Aktekin, Lale

SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME

Selma EROĞLU, (Afyonkarahisar Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Afyonkarahisar, Türkiye)

Lale AKTEKİN, (Yıldırım Beyazıt Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Türkiye)

Hatice BODUR (Ankara Numune Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Ankara, Türkiye)

Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi

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Yıl: 2020 Cilt: 21 Sayı: 3 Sayfa Aralığı: 222 - 229 Metin Dili: İngilizce İndeks Tarihi: 01-12-2020

SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME

Öz:

OBJECTIVE: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. The diagnosis is basedon the history, clinical signs and symptoms of the patient,but electrodiagnostic studies are done to confirm the di- agnosis and to manage the treatment. This study aimedto assess sensitivities of clinical symptoms, provocativetests and electrodiagnostic studies (EDS) in patients withidiopathic mild CTS.MATERIAL AND METHODS:The study included 90 han- ds of 75 patients with idiopathic mild CTS and 30 handsof 15 healthy volunteers. The patients were questionedfor symptoms in the innervation area of the median ner- ve such as pain, paresthesia, weakness in the hand andnumbness and pain worsening at night, relief from thesymptoms by shaking hands. Tinel and Phalen tests weredone. The EDS included; motor, mixed and sensorial (di- gits 1-2-3-4 and palm) nerve conduction studies (NCS)for median nerve; motor, mixed and sensorial (fifth digit)NCS for ulnar nerve, sensorial NCS (first digit) for radialnerve, median and ulnar F waves. The values for distal la- tency and nerve conduction velocity (NCV) were calcula- ted for all studied nerves. Sensitivities of median sensorydistal latency and NCV to digits 1,2,3,4 and palm-wristsegments and sensitivities of the following comparativetests were detected; median-radial sensory distal latencydifference (SDLD) to the first digit, median-ulnar SDLD tothe fourth digit, median-ulnar SDLD to the digits 2-5, 3-5,4-5 and median-ulnar F latency difference.RESULTS: The most common symptoms in patients with idiopathic mild CTS were paresthesia (95.6%) and noc- turnal numbness (88.8%). The sensitivity of Phalen’s andTinel’s tests were 67.8% and 56.7%, respectively. Amongthe EDS, first digit and palm-wrist sensorial NCV were themost sensitive tests (98.9%). Of the comparative tests,median-ulnar SDLD to digits 4-5 was the most sensitiveone (93.3%). Median-ulnar F latency difference had thelowest sensitivity (38.9%).CONCLUSIONS: The most sensitive EDS were first digit and palm-wrist sensorial NCV. Median-ulnar SDLD to di- gits 4-5 was more sensitive than the other tests. With useof these tests, the diagnostic sensitivity of EDS may beincreased in patients with mild CTS.

Anahtar Kelime:

İDİYOPATİK HAFİF KARPAL TÜNEL SENDROMLU HASTALARDA FARKLI ELEKTRODİAGNOSTİK ÇALIŞMALARIN DUYARLILIĞI

Öz:

AMAÇ: Karpal Tünel Sendromu (KTS) en sık görülen tuzak nöropatisidir. Tanısı klinik bulgularla ile konulabilir, ancak tanıyı doğrulamak ve tedaviyi planlamak için elektrodiag- nostik çalışmalara ihtiyaç vardır. Bu çalışmada, idiyopatik hafif KTS’li hastalarda klinik semptomlar ve provokatif testler ile elektrodiagnostik testlerin duyarlılığını değer- lendirmek amaçlandı. GEREÇ VE YÖNTEM: Çalışmaya 75 idiyopatik hafif KTS tanılı hasta (90 el) ve 15 sağlıklı gönüllü (30 el) alındı. Has- talarda median sinir innervasyon alanında ağrı, parestezi, elde güçsüzlük, uyku sırasında artan ağrı ve uyuşma ile elleri silkeleme ile şikayetlerde rahatlama semptomları sorgulandı; Tinel ve Phalen testleri yapıldı. Elektrodiag- nostik incelemede; median sinir motor, miks, 1-2-3-4. parmak ve avuç içi duyusal iletim çalışmaları, ulnar sinir motor, miks ve 5.parmak duyusal iletim çalışmaları, medi- an ve ulnar F dalgası, radial sinir 1.parmak duyusal iletim çalışması yapıldı. Çalışılan tüm sinirler için distal latans ve sinir iletim hızı değerleri hesaplandı. Parmak (1, 2, 3, 4) ve avuç içi median duyusal distal latansları ve iletim hızlarının; karşılaştırmalı elektrodiagnostik testlerden 1. parmaktan median-radial duyusal distal latans farkının (DDLF), 4. parmaktan median-ulnar DDLF, 2-5, 3-5, 4-5. parmaklar arasında median-ulnar DDLF; median ve ulnar F dalgası latans farklarının duyarlılığı hesaplandı. BULGULAR: İdiyopatik hafif KTS’li hastalarda en sık rast- lanan iki semptom parestezi (%95.6) ve gece uyuşması (%88.8) idi. Phalen testi ve Tinel testlerinin duyarlılığı sı- rasıyla %67.8 ve %56.7 olarak bulundu. Elektrodiagnostik testlerin sonuçları değerlendirildiğinde, 1.parmak-bilek ve avuç içi-bilek segmenti duyusal iletim hızı çalışmaları %98.9 ile duyarlılığı en yüksek testler olarak bulundu. Uy- gulanan karşılaştırmalı testlerden 4-5.parmak median-ul- nar DDLF %93.3 ile en duyarlı karşılaştırmalı test olarak tespit edildi. Median-ulnar F latans farkı duyarlılığı en dü- şük test (%38.9) olarak saptandı. SONUÇ: En duyarlı elektrodiagnostik testler 1. par- mak-bilek ve avuç içi-bilek segmenti duyusal iletim hızıy- dı. 4-5 parmak median-ulnar DDLF diğer karşılaştırmalı sinir iletim çalışmalarından daha duyarlı olarak bulundu. KTS elektrodiagnostik tanısında bu testlerin kullanılması ile duyarlılık arttırılabilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Eroğlu S, Aktekin L, Bodur H (2020). SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. , 222 - 229.
Chicago	Eroğlu Selma,Aktekin Lale,Bodur Hatice SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. (2020): 222 - 229.
MLA	Eroğlu Selma,Aktekin Lale,Bodur Hatice SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. , 2020, ss.222 - 229.
AMA	Eroğlu S,Aktekin L,Bodur H SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. . 2020; 222 - 229.
Vancouver	Eroğlu S,Aktekin L,Bodur H SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. . 2020; 222 - 229.
IEEE	Eroğlu S,Aktekin L,Bodur H "SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME." , ss.222 - 229, 2020.
ISNAD	Eroğlu, Selma vd. "SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME". (2020), 222-229.

APA	Eroğlu S, Aktekin L, Bodur H (2020). SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi, 21(3), 222 - 229.
Chicago	Eroğlu Selma,Aktekin Lale,Bodur Hatice SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi 21, no.3 (2020): 222 - 229.
MLA	Eroğlu Selma,Aktekin Lale,Bodur Hatice SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi, vol.21, no.3, 2020, ss.222 - 229.
AMA	Eroğlu S,Aktekin L,Bodur H SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi. 2020; 21(3): 222 - 229.
Vancouver	Eroğlu S,Aktekin L,Bodur H SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME. Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi. 2020; 21(3): 222 - 229.
IEEE	Eroğlu S,Aktekin L,Bodur H "SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME." Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi, 21, ss.222 - 229, 2020.
ISNAD	Eroğlu, Selma vd. "SENSITIVITIES OF THE ELECTRODIAGNOSTIC TESTS IN IDIOPATHIC MILD CARPAL TUNNEL SYNDROME". Afyon Kocatepe Üniversitesi Kocatepe Tıp Dergisi 21/3 (2020), 222-229.