A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb.
Affiliation
Department of Neurophysiology, Cork University Hospital, Cork, Ireland.Issue Date
2010MeSH
Age FactorsArm
Carpal Tunnel Syndrome
Female
Humans
Male
Middle Aged
Nerve Compression Syndromes
Neural Conduction
Retrospective Studies
Sex Factors
Metadata
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A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb. 2010, 63 (1):11-6 Eur. Neurol.Publisher
KargerJournal
European neurologyDOI
10.1159/000258635PubMed ID
19923839Abstract
Entrapment neuropathies, particularly those affecting upper limbs, are common reasons for referral for nerve conduction studies (NCS). However, concordance between clinical findings and NCS findings, especially in patients being considered for intervention including decompressive surgery, has not been assessed.We conducted a retrospective study using records from a tertiary referral centre's neurophysiology database. We aimed to establish the proportions of agreement between the suspected clinical diagnosis as defined by the referring clinician and NCS findings in the setting of an upper limb entrapment neuropathy.
Of the 571 referrals for NCS, suspected bilateral carpal tunnel syndrome was the commonest reason for referral (30.5%). In total, there was 51.5% concordance between suspected clinical diagnosis and NCS findings. Patients with NCS evidence of an entrapment neuropathy (n = 437) were more likely to be older compared to those with normal studies (54.0 +/- 15.6 years vs. 45.9 +/- 13.4 years, p < 0.001). Those with normal NCS findings were more likely to be female (72%, p = 0.001). An alternative or additional diagnosis was found in 14%.
This study raises concerns regarding the appropriateness of referral for decompressive surgery based on clinical diagnosis alone as many have an additional or alternative diagnosis as suggested by NCS findings.
Item Type
ArticleLanguage
enISSN
1421-9913ae974a485f413a2113503eed53cd6c53
10.1159/000258635