Electrophysiological Staging of Carpal Tunnel Syndrome

Abstract

We report on electrophysiological staging in 20 patients (27 hands) with carpal tunnel syndrome (C. T. S.) in subjects ranged in from 33 to 64 years.
In C. T. S. the degree of axonal degeneration relates to the amplitude of the sensory nerve action potential which is recorded distal to the transverse carpal ligament. Segmental demyelination cases have delay in their nerve conduction velosity. Mixedtype cases have a low amplitude action potential recorded from digits after palm stimulation. Axonal degeneration cases are those in which the action potential could not be recorded.
The degree of sensory disturbance relates to the degree of axonal degeneration. Neuropathological findings of entrapment neuropathy are a mixture of some degree of demyelination and axonal degeneration.
The degree of axonal degeneration is important for prognosis in C. T. S.. We emphasize not noly the electrophyiological staging but also the conduction velosity of nerve action potentials.