• Annals of Clinical Neurophysiology
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• v.4 no.2
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• pp.108-113
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• 2002

Background and Objective : Carpal tunnel syndrome (CTS) is the most common mononeuropathy encountered in clinical practice. No single procedure or group of procedures has demonstrated adequate sensitivity. F-wave study in CTS is very rarely reported. To determine the diagnostic usefulness of new parameters of F-wave and comparative study of F-wave parameters of median and ulnar nerves in patients with CTS. Methods : F-wave responses of median and ulnar nerves were analyzed from 27 patients with clinically diagnosed CTS and 22 age and gender-matched normal control. Conventional F-wave parameters were studied. Also, the usefulness of new parameters such as mean and maximal ulnar-median F-wave latency differences, ulnar-median F-wave persistence and chronodispersion differences, median/ulnar F-wave amplitude ratio, and F-wave conduction velocity (FCV) using mean and maximal latency were assessed. Results : Compared with controls, median F-wave minimal, maximal and mean latencies, mean F-wave amplitude/M-wave amplitude, minimal, mean and maximal ulnar-median F-wave latency differences, and FCVs using minimal, maximal and mean latency were significant (P<0.05~0.001). Median F-wave minimal, maximal and mean latencies, mean ulnar-median F-wave latency difference, and FCVs using minimal, maximal and mean latency showed high sensitivity and specificity. Mean ulnar-median F-wave latency difference and FCVs using maximal and mean latency were new parameters. Conclusion : New F-wave parameter including mean ulnar- median F-wave latency difference and FCVs using maximal and mean latency may be a useful to assess the CTS. Also, median F-wave minimal, maximal and mean latencies, and FCV using minimal latency may be included in routine diagnostic tests in CTS.

• Annals of Clinical Neurophysiology
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• v.2 no.2
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• pp.89-94
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• 2000

Purpose : Carpal tunnel syndrome (CTS) is a disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and nerve conduction study (NCS). However, sometimes, NCS does not provide a reliable evidence to reach the diagnosis. Thus, authors performed this study to determine whether NCS was correlated with specific parameters measured on magnetic resonance imaging (MRI) which might become a potential complemental diagnostic tool. Methods : We performed MRI in 34 wrists of 18 patients with clinical manifestations of CTS and pathologic nerve conduction values and analyzed them at levels of the distal radioulnar joint, pisiform and hook of hamate, Results : Increase in the cross-sectional area of the median nerve at the pisiform level and flattening, increased signal intensity, and contrast enhancement of the median nerve at levels of the pisiform and hook of hamate were statistically significant. Change in cross sectional areas between the distal radioulnar joint and hamate and the signal intensities at levels of pisiform and hamate were well correlated with the median nerve conduction velocity. Conclusions : Characteristic MRI findings in CTS reported previously were well demonstrated and some of MRI parameters are well correlated with nerve conduction study. MRI, despite cost, may help in evaluating CTS.

• Annals of Clinical Neurophysiology
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• v.15 no.1
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• pp.7-12
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• 2013

Background: Local steroid injection is used to treat carpal tunnel syndrome (CTS). The aim of this study was to evaluate the clinical and electrophysiological effects of local steroid injection in patients with CTS over a 3-months period. Methods: Twenty-one patients (35 hands) with clinical and electrophysiological evidence of CTS were treated by injection of triamcinolone 40 mg to the carpal tunnel. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), rates of paresthesia, night awakening, and electrophysiological studies were used as outcomes. Clinical and electrophysiological assessments were performed before, 1 and 3 months after treatment. Results: Prior to treatment, 86% of patients complained of night awakening. At 1 and 3 months after injection, only 17% and 29% of the patients, respectively, had night awakening (p<0.001). All patients complained of paresthesia before the treatment. This symptom disappeared in 60% and 31% of the patients after 1 and 3 months, respectively (p<0.001). Compared to baseline, both BCTQ and VAS show significant improvement during the 3 months of the study (p<0.005). Although significant improvements in clinical parameters were shown, electrophysiological parameters were not significantly improved at 1 and 3 months. Conclusions: Local corticosteroid injection for the treatment of CTS provides significant improvement in symptoms for 3 months. On the other hand, no significant improvement was observed in electrophysiological parameters.

• Journal of Korean Neurosurgical Society
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• v.29 no.11
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• pp.1451-1455
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• 2000

Objective : The goal of this study is to present whether endoscopic release(ER) is superior to open release(OR) for the treatment of carpal tunnel syndrome(CTS). Method and Material : Fifty-nine wrists in 43 patients who had clnical signs and symptoms consistent with CTS, not responded to non-operative management, were entered into the study. Authors retrospectively compared 27 wrists treated with ER(February 1999-June 1999) with 32 wrists treated with OR(October 1997-March 1999). We performed conventional open surgery in 25 patients(mean age ; 46 years) and Brown's two-portal technique in 18 patients(mean age ; 53 years) under intravenous regional block or general anesthesia. Results : Sixteen patients had CTS on both hands and left hands were affected more frequently than right hand, 34 and 25 respectively. Successful and poor results of ER were similar to those of OR. For patients in OR group, mean duration of symptoms was 5 years(range 1 month-30 years), and postoperative outcome was good in 27(84.4%) of wrists and poor in 5(15.6%). For patients in ER group, mean duration of symptoms was 7 months (range 2 months-25 years), outcome was good in 23(85.2%) of wrists and poor in 4(14.8%). The average time for complete relief of pain was 1.3 weeks and 7.6 weeks, respectively for OR and ER groups. No complication was noted in either group. Conclusion : This preliminary analysis suggests that faster relief of pain was achieved when the endoscopic method was used, although there were no significant differences in their efficacies regarding the improvement of symptoms.

• Physical Therapy Korea
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• v.16 no.1
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• pp.61-69
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• 2009

The objective of this study was to investigate the relationship between addiction to online games and carpal tunnel syndrome (CTS) in college students. A total of 377 (205 male and 172 female) college students completed an online game addiction scale, a Symptom Severity Scale (SSS), and a Function Status Scale (FSS) for CTS. It was found that five (1.3%) students were diagnosed with an online game addiction, 74 (19.6%) students were diagnosed with a pre-addiction to online games, and 298 (79.0%) students were diagnosed as being average users. The pre-addiction group had significantly higher scores on the SSS than did the average user group (p<.05). The average user group scored significantly lower than did the online game addiction group (p<.05). Symptoms of wrist pain and hand numbness in the daytime were common in the addiction group. There were statistically significant but poor positive relationships between the online game addiction scale and the SSS (r=.312, p<.01), and between the online game addiction scale and the FSS (r=.149, p<.01). The information about online game addiction and CTS identified in this study could contribute to the prevention of online game addiction and CTS in college students.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.21-26
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• 2014

Background: Electrophysiological study has been known as a useful method to evaluate the therapeutic effect of operation in idiopathic carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the clinical and electrophysiological changes after carpal tunnel release (CTR) compared to the preoperative results. Methods: We analyzed the changes of nerve conduction study (NCS) before and after minimal open carpal tunnel release in 18 patients (25 hands) with CTS. Follow-up study was performed over 6 months after operation. Results: Clinical improvement was seen in all cases after CTR. In contrast, electrophysiological improvement was various depending on the parameters; the mean median sensory latency and nerve conduction velocity (NCV) improved significantly (p = 0.001). The mean median motor latency also improved, but NCV and compound muscle action potential (CMAP) amplitude did not change. The extent of improvement was evident in moderate CTS, but not in severe CTS. Conclusions: In this preliminary study, all subjects who underwent CTR achieved a clinical relief along with a significant improvement of electrophysiological parameters such as median sensory latency, sensory NCV and median distal motor latency. After CTR, a number of cases with mild to moderate CTS showed a prominent improvement of clinical and electrophysiological parameters, while fewer improvements were seen in severe CTS, although it did not reach the statistical significance.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.2
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• pp.107-115
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• 2009

Purpose：This study was to determine whether median nerve mobilization has any effect on the recovery of muscle power and the reduction of pain for the patients with carpal tunnel syndrome. Methods：20 patients suffering from carpal tunnel syndrome were randomly divided into two groups: 10 subjects treated both with electrical therapy and median nerve mobilization(experimental group) and the other 10 subjects treated only with electrical therapy(control group). The therapy was taken three times a week for 3 weeks. Results：The grip strength increased in both groups. However, the experimental group showed more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. In terms of pain, both groups showed significant effects. But the experimental group showed but more significant treatment effect than the control group, and the significant changes appeared every week during the experiment period. Conclusions：It was significantly more effective for the patients with carpal tunnel syndrome to apply median nerve mobilization during the electrical therapy in order to reduce pain and to increase grip strength, compared with the method only using electrical therapy. Further research should be conducted to generalize these results in terms of the clinical effectiveness of the nerve mobilization.

• Korean Journal of Clinical Laboratory Science
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• v.37 no.3
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• pp.212-215
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• 2005

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in clinical practice, with a 0.1% life time risk in the general population. Conventional neurophysiological studies have been useful in the diagnosis of this condition, as have a number of more specialized procedures. Therefore, we evaluated the diagnostic sensitivities of several parameters in nerve conduction technique for CTS patients. We analyzed 100 patients (159 hands) who were diagnosed with CTS clinically and electrophysiolosically. Median motor and sensory nerve conduction velocities (MCV and SCV) with wrist, palm, and finger stimulation were performed in traditional methods. Sensitivities of each test were calculated and compared to normal control data. The sensitivities of existing nerve conduction method were noted in terminal latency on median nerve, 2nd finger-wrist segment, 3rd finger-wrist segment, palm-wrist segment and distoproximal ratio, as 72.96%, 92.45%, 94.34%, 94.97%, and 97.48%, respectively. In the early course of CTS, sensory nerve conductions in the median nerve are more valuable than motor nerve conduction. Sensory nerve conductions are usually affected before motor nerve conductions in CTS. In this study, we detected that slowing of median SCV was the most frequent in the distoproximal ratio.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.3
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• pp.55-64
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• 2022

Objectives The objective of this study was to assess the effectiveness of acupotomy for carpal tunnel syndrome. Methods Based on seven domestic and foreign databases. We analyzed the randomized controlled trials using acupotomy for carpal tunnel syndrome. The treatment group was treated with acupotomy and the control group was no restrictions on treatment methods. Results In this study, the effect of acupuncture treatment for carpal tunnel syndrome was investigated. Each study reported that acupotomy could be an effective treatment for carpal tunnel syndrome. However, as a result of meta-analysis of Levine carpal tunnel syndrome questionnaire scores, visual analog scale, and sensory nerve conduction velocity, the results were more clinically significant than those of the control group. Due to the small number of randomized controlled trial studies and the nature of acupotomy treatment, blinding of interventions was impossible, resulting in a high risk of bias. Conclusions In this regard, it is thought that well-planned randomized controlled studies on patients with carpal tunnel syndrome are needed in the future to secure the clinical evidence for acupotomy treatment.

• Annals of Clinical Neurophysiology
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• v.12 no.2
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• pp.55-60
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• 2010

Background: The aim of this study is to identify the correlation between ultrasonographic findings of median nerve and clinical scale and electrophysiologic data in carpal tunnel syndrome. Methods: Forty three patients (79 hands) with electrophysiologically confirmed carpal tunnel syndrome were evaluated. Clinical symptoms were examined by Historical-Objective (Hi-Ob) scale. Electrophysiologic data and Padua scale were used for severity of electrophysiology. In ultrasonographic study, cross sectional area and flattening ratio of median nerve were measured at distal wrist crease level (DWC), 1cm proximal to distal wrist crease level, and 1cm distal to distal wrist crease level. The correlation between Hi-Ob scale, electrophysiologic data and ultrasonography was measured with Spearman rank test. Results: The mean Hi-Ob scale was 2.4. Mean Padua scale was 4.0. In ultrasnonographic study, cross sectional area and flattening ratio were $0.112\;cm^2{\pm}0.025$ and $3.0{\pm}0.6$ at 1cm proximal to DWC level, $0.118{\pm}0.026\;cm^2$ and $2.9{\pm}0.4$ at DWC level, and $0.107{\pm}0.032\;cm^2$ and $3.0{\pm}0.4$ at 1 cm distal to DWC level. Hi-Ob scale was not correlated with cross sectional area and flattening ratio of median nerve. Hi-Ob scale was correlated with Padua scale positively (r=0.44) and correlated with amplitudes of CMAP and SNAP, negatively (r=-0.33; r=-0.30). Cross sectional area of median nerve was significantly correlated with Padua scale, amplitudes and latencies of CMAP and amplitudes of SNAP. Conclusions: Ultrasonographic findings of median nerve and electrodiagnostic data had statistically significant correlation. Consequently, ultrasonography could be an adjunctive method in diagnosis of carpal tunnel syndrome.