环指感觉神经感觉传导速度在轻度腕管综合征诊断中的应用

目的 寻找诊断轻度腕管综合征(CTS)敏感的电生理检查方法。方法 临床症状、体征符合CTS,正中神经运动末端潜伏期正常的患者19例(29侧)和年龄性别相匹配的健康对照组23名(25侧),采用顺向性感觉神经传导速度(SCV)测定法分别测定环指(指4)正中神经和尺神经SCV,中指(指3)正中神经SCV。结果 环指尺神经SCV>45.2 m/s,正中神经SCV<44.1 m/s,和(或)尺神经SCV与正中神经SCV差值>8.1 m/s(x+σx),考虑符合CTS诊断。CTS组中指正中神经SCV测定异常率为66％,环指为76％,环指正中神经与尺神经SCV差值异常率为93％。环指刺激在8例(14侧)患者腕部正中神经处记录到双峰电位,但对照组均未见。结论 比较环指正中神经和尺神经SCV在鉴别轻度CTS方面是敏感的方法之一,在怀疑CTS时,该项检查可作为常规的电生理检查方法。

Median and ulnar ring finger sensory conduction velocity in mild carpal tunnel syndrome

Objective To find a sensitive electrodiagnostic method for patients with mild carpal tunnel syndrome (CTS). Methods 29 hands with recent onset symptoms and signs of CTS but with normal median distal motor latency, and 23 sex and age-matched normal controls (25 hands) were studied and the sensory conduction velocity ( SCV ) was recorded from the fourth digit ( D4 ) and the third digit ( D3 ) . Results D4 ulnar nerve (UN) SCV <45. 2 m/s, median nerve (MN) SCV <44. 1 m/s, and (or) the median and ulnar sensory conduction velocity difference > 8. 1 m/s were considered to be confirmed with the diagnosis of CTS. While the abnormal rate from MN D3 was 66% , and MN D4, 76% , with a SCV different rate between D4 MN and UN being 93%. There appeared a double-peak potential measured over the median nerve with CTS after D4 stimulation (8/14 hand) but not found in control hands. Conclusion Comparison of median and ulnar D4 SCV should be a very sensitive method for detecting mild CTS. The median and ulnar sensory conduction velocity difference >8. 1 m/s and (or) double peak potential recorded over the median nerve allows immediate dignosis of CTS. The ring finger technique should be recorded for the early diagnosis of CTS.