Electrophysiological Grading of Carpal Tunnel Syndrome

Background: Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy caused by a conduction block of distal median nerve at wrist. Women are affected more commonly than men. Clinical signs are quite helpful in diagnosis but electrophysiological tests yield accurate diagnosis and severity grading along with follow-up and management. Aim: To utilize nerve conduction studies (NCS) to diagnose carpal tunnel syndrome and further classify its severity according to the AAEM criteria. Methods: This descriptive study was conducted at the Department of Neurology, Sh. Zayed Medical College/Hospital, Rahim Yar Khan from June 2013 to Dec 2014. Overall, 90 patients and 180 hands were evaluated through nerve conduction studies. Patients with clinically high suspicion of CTS were included for NCS. Clinical grading was done using the AAEM criteria for CTS. Other variables like duration of symptoms, handedness, bilateral disease and gender were noted. Mean and median were calculated for age of the patients. Results: Ninety patients and 126 hands were identified with carpal tunnel syndrome. Most patients (80%) were females with age range from 19 to 75 years. More than one third had bilateral disease. Dominant hand was involved in majority of the patients. Most patients had (42.8%) severe CTS as per AAEM criteria. Also duration of symptoms directly correlated with severity of disease. Conclusion: Nerve conduction study is a valuable tool in accurate diagnosis and grading of carpal tunnel syndrome.