Annals of Clinical Neurophysiology

  • 제19권1호
  • /
  • Pages.13-19
  • /
  • 2017
  • /
  • 2508-691X(pISSN)
  • /
  • 2508-6960(eISSN)
대한임상신경생리학회 (The Korean Society of Clinical Neurophysiology)
권호 표지
DOI QR코드

DOI QR Code

Median and ulnar F-wave inversion as a supplementary criterion for diagnosis of carpal tunnel syndrome

  • Kim, Yoohwan (Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Jang, Jae-Hong (Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Cho, Charles S. (Department of Neurology, Stanford University School of Medicine) ;
  • Kim, Byung-Jo (Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine)
  • 투고 : 2016.07.15
  • 심사 : 2016.11.09
  • 발행 : 2017.01.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Median F-wave latencies are physiologically shorter than ulnar latencies, but they are often longer relative to ulnar latencies in carpal tunnel syndrome (CTS). This study aimed to investigate the value of absolute F-waves and relative latency changes compared to ulnar latencies in the diagnosis of CTS. Methods: F-wave latencies of median and ulnar nerves in 339 hands from 339 patients with CTS and 60 hands from 60 control subjects were investigated. Mean F-wave minimal latencies of median and ulnar nerves were compared between groups. Patients were further divided into subgroups based on Canterbury grading and then analyzed using F-wave latency differences (FWLD) and F-wave ratio (FWR). Results: Of 339 hands in the CTS group, 236 hands exhibited F-wave inversion based on the FWLD criterion and 277 hands had F-wave inversion based on the FWR criterion. F-wave inversion had a sensitivity of 81.7% using the FWR criterion to diagnose CTS. The mean FWLD and FWR were significantly greater in all patient subgroups compared to the control group (p < 0.001). In addition, mean FWLD and FWR showed significant correlations (r = -0.683 and r = 0.674, respectively, p < 0.001) with disease severity. Conclusions: F-wave studies are effective supplementary diagnostic tools comparing to other standard electrophysiologic criteria for screening patients with CTS.

키워드

참고문헌

  1. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282:153-158. https://doi.org/10.1001/jama.282.2.153
  2. Silverstein BA, Fine LJ, Armstrong TJ. Occupational factors and carpal tunnel syndrome. Am J Ind Med 1987;11:343-358. https://doi.org/10.1002/ajim.4700110310
  3. de Krom MC, Kester AD, Knipschild PG, Spaans F. Risk factors for carpal tunnel syndrome. Am J Epidemiol 1990;132:1102-1110. https://doi.org/10.1093/oxfordjournals.aje.a115753
  4. D'Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? JAMA 2000;283:3110-3117. https://doi.org/10.1001/jama.283.23.3110
  5. American Association of Electrodiagnostic Medicine, American Academy of Neurology, and American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 2002;25:918-922. https://doi.org/10.1002/mus.10185
  6. Sander HW, Quinto C, Saadeh PB, Chokroverty S. Sensitive median-ulnar motor comparative techniques in carpal tunnel syndrome. Muscle Nerve 1999;22:88-98. https://doi.org/10.1002/(SICI)1097-4598(199901)22:1<88::AID-MUS13>3.0.CO;2-C
  7. Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 2011;44:597-607. https://doi.org/10.1002/mus.22208
  8. Robinson LR, Micklesen PJ, Wang L. Strategies for analyzing nerve conduction data: superiority of a summary index over single tests. Muscle Nerve 1998;21:1166-1171. https://doi.org/10.1002/(SICI)1097-4598(199809)21:9<1166::AID-MUS7>3.0.CO;2-5
  9. Menkes DL, Hood DC, Bush AC. Inversion of the F-waves in median neuropathy at the wrist (carpal tunnel syndrome): an adjunctive electrodiagnostic method. J Contemp Neurol 1997;1:1-10.
  10. Cevik MU, Altun Y, Uzar E, Acar A, Yucel Y, Arikanoglu A, et al. Diagnostic value of F-wave inversion in patients with early carpal tunnel syndrome. Neurosci Lett 2012;508:110-113. https://doi.org/10.1016/j.neulet.2011.12.030
  11. Aygul R, Kotan D, Ulvi H, Kuyucu M, Ozdemir G, Ertekin A, et al. The relationship of median nerve F-wave parameters with severity and subtypes of carpal tunnel syndrome. J Back Musculoskelet Rehabil 2014;27:1-6. https://doi.org/10.3233/BMR-130409
  12. Park KM, Shin KJ, Park J, Ha SY, Kim SE. The usefulness of terminal latency index of median nerve and f-wave difference between median and ulnar nerves in assessing the severity of carpal tunnel syndrome. J Clin Neurophysiol 2014;31:162-168. https://doi.org/10.1097/WNP.0000000000000041
  13. Alemdar M. Value of F-wave studies on the electrodiagnosis of carpal tunnel syndrome. Neuropsychiatr Dis Treat 2015;11:2279-2286.
  14. Bland JD. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve 2000;23:1280-1283. https://doi.org/10.1002/1097-4598(200008)23:8<1280::AID-MUS20>3.0.CO;2-Y
  15. Kuntzer T. Carpal tunnel syndrome in 100 patients: sensitivity, specificity of multi-neurophysiological procedures and estimation of axonal loss of motor, sensory and sympathetic median nerve fibers. J Neurol Sci 1994;127:221-229. https://doi.org/10.1016/0022-510X(94)90076-0
  16. Mondelli M, Aretini A. Low sensitivity of F-wave in the electrodiagnosis of carpal tunnel syndrome. J Electromyogr Kinesiol 2015;25:247-252. https://doi.org/10.1016/j.jelekin.2014.12.002
  17. Jablecki CK, Andary MT, Floeter MK, Miller RG, Quartly CA, Vennix MJ, et al. Practice parameter: electrodiagnostic studies in carpal tunnel syndrome. Report of the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2002;58:1589-1592. https://doi.org/10.1212/WNL.58.11.1589