This study was designed to evaluate the usefulness of a new multielectrode stimulator, TenElectrodes, in the diagnosis and localization of the compression site in the wrists of carpal tunnel syndrome (CTS) patients. Antidromic inching technique (IT) of the median nerve at the wrist was performed with the TenElectrodes, on 46 controls and 21 CTS patients. In controls, mean conduction delay per centimeter (CD/cm) was 0.21 milliseconds (ms), and maximal CD/cm was 0.27 ms in the segment 3 to 4 centimeters distal to the distal wrist crease. The abnormal cut-off value, calculated as the maximal CD/cm + 2SD, was 0.45 ms. In the CTS group, the maximal CD/cm was 0.56 ms in the segment 2 to 3 centimeters distal to the distal wrist crease, and the CD/cm values in all segments between the distal wrist crease and 4 cm distal to the distal wrist crease were greater than 0.45 ms. Antidromic IT using TenElectrodes may be an easy, fast and accurate method as the electrodes of the stimulator are aligned at 1-cm intervals and are adjustable to the wrist contour by springs.
Adult ; Aged ; Carpal Tunnel Syndrome/*diagnosis/physiopathology ; *Electrodes ; Electrodiagnosis/*instrumentation ; Equipment Design ; Female ; Human ; Male ; Middle Aged ; Muscle, Skeletal/physiopathology ; Neural Conduction ; Neurons, Afferent/physiology ; Reaction Time

The objective of this study was to compare the MRI findings of wrists in patients diagnosed with CTS with those of the healthy controls, and to evaluate the correlation between the MRI differences and the electrophysiological findings in the patient group. This study involved 55 wrists, 30 of which were clinically and electrophysiologically diagnosed with CTS and 25 healthy controls. These 55 wrists were evaluated electrophysiologically, and in terms of median nerve diameter, ratio of median nerve diameter at psiform bone level to distal radio-ulnar joint level, the flexor retinaculum bulging ratio and the median nerve intensity by MRI. When the patient group, which were clinically and electrophysiologically diagnosed with CTS, and the healthy control group were compared, a significant difference (p < 0.001) was observed between the two in terms of median nerve diameters (at psiform bone level: 8.47 +/- 1.41mm and 2.91 +/- 1.01 mm, distal radio-ulnar joint level: 4.04 +/- 1.06 mm and 2.42 +/- 0.95 mm), ratio of median nerve diameter at psiform bone level to distal radio-ulnar joint level (2.17 +/- 0.54 and 1.25 +/- 0.12), their flexor retinaculum bulging ratios (26.21 +/- 5.98% and 7.27 +/- 4.53%) and their median nerve intensities. In the patient group, no significant correlation between MRI and the electrophysiological findings was found (p > 0.05). According to the data obtained from the study, we believe that the MRI examination of structural changes that occur in the carpal tunnel, neighboring structures and the median nerve would be useful in the diagnosis of CTS, especially in cases with suspected clinical and electrophysiological diagnosis.
Action Potentials ; Adult ; Carpal Tunnel Syndrome/*diagnosis/*physiopathology ; Electrophysiology ; Female ; Human ; *Magnetic Resonance Imaging ; Male ; Median Nerve/physiopathology ; Middle Aged ; Neurons, Afferent/physiology ; Reaction Time ; Reference Values