Needle electromyography in carpal tunnel syndrome

The role of needle electromyography (EMG) in the routine evaluation of carpal tunnel syndrome (CTS) is not clear. The aim of this study was to determine if needle EMG examination of the thenar muscles could provide useful information in addition to the nerve conduction (NC) studies. Electrophysiologic procedures performed on 84 patients (103 hands) consistent with CTS were reviewed. The median thenar motor NC data were matched with the needle EMG findings in the abductor pollicis brevis (APB) muscle. The severity of the needle EMG findings in the APB muscle correlated well with the severity of the motor NC data. As the thenar compound muscle action potential amplitude decreased and the degree of nerve conduction slowing and block across the wrist increased, there was a corresponding increase in the number of enlarged motor units and decrease in the recruitment pattern in the needle EMG findings. Needle EMG examination confined to the thenar muscles in CTS does not seem to provide any further information when the NC data had already established this diagnosis, and it should not be performed routinely.