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Comparison of second lumbrical interosseous median and ulnar motor conduction study in population of subjects with idiopathic carpal tunnel syndrome and non-CTS hands-a cross-sectional study

Balaji W Ghughare, Dharmendra M Dodiya, Satyendra Prajapati.



Abstract
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Background: Second lumbrical interosseous (2L-I) median-ulnar motor conduction study across wrist is pivotal in electrodiagnosis of carpal tunnel syndrome (CTS) in different grades of severity. 2L-I Median versus ulnar distal motor latency (DML) difference more than 0.5 milliseconds is used to diagnose median neuropathy at wrist. Other variables of study, namely, 2L DML, compound muscle action potential (CMAP) amplitude, CMAP duration, and conduction velocity (CV) remain less explored with few studies pressing for its role to substantiate CTS diagnosis.

Aims and Objectives: Current cross-sectional study aimed to explore role of 2L-I DML, amplitude, duration, and CV in diagnosis of median neuropathy at wrist.

Materials and Methods: Total 70, 37 clinically suspected CTS hands and 33 age, height, and weight matched non-CTS hands underwent 2L-I Median Ulnar motor conduction study.

Results: Statistically significant difference (P < 0.05) in 2L median DML, CMAP amplitude, duration and CV between CTS and non-CTS hands along with 2L-I Median versus Ulnar DML difference. 2L DML and 2L-I DML difference variables showed better specificity and sensitivity: 83.78 and 93.91, respectively, in diagnosing CTS.

Conclusion: We concluded that apart from 2L-I DML difference other variables such as DML, amplitude, duration, and CV may also play substantial role in evaluation of CTS and may be included as part of electrodiagnostic protocol.

Key words: Carpal Tunnel Syndrome; Motor Conduction Study; Neuropathy; Electrodiagnosis







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