To verify the feasibility of initial parameters of ultrasonography or electromyography for the prediction of effect after steroid injection therapy in a carpal tunnel syndrome (CTS) patient.
We recruited individuals with clinical and electrodiagnostic evidence of CTS. Results from the Boston self-assessment questionnaire, median motor and sensory nerve conduction studies, and median nerve ultrasonography were evaluated at baseline, 1 month, and 6 months after injection. Evaluation of median nerve ultrasonography parameters included measurements taken at the maximal swelling point (MS), 2 cm proximal from MS (2MS), and 12 cm proximal from MS (12MS), and its ratio (MS/12MS, 2MS/12MS) was calculated. The correlation between improvement of the symptom score after treatment and baseline parameters was estimated.
Fourteen individuals (14 women, mean age 53.8 years) with 22 affected wrists were enrolled. After steroid injection therapy, clinical and electromyographic parameters showed significant improvements at 1 month or 6 months after injection, and ultrasonographic parameters showed significant changes in maximal area and area ratio (MS/12MS) of the median nerve. Symptom score improvement showed a positive correlation in the initial 2MS and ratio of 2MS/12MS after 6 months (p<0.05).
Most of the improvements occurred during the first month after injection and lasted up to 6 months. The initial median nerve swelling and its ratio may be a useful predictor of response after steroid injection.
Citations
Objective: The purpose of this study is to find out whether amplitude ratio and area ratio have correlation with nerve conduction velocity in the diabetes mellitus patients.
Method: Median and deep peroneal motor nerve conduction study was performed in thirty-five normal control group and sixty diabetes mellitus patients group. The motor conduction velocity, amplitude ratio, and area ratio of the compound muscle action potential (CMAP) were measured. The experimental subjects were divided into 6 subgroups (in median nerve: M1, M2, M3, in peroneal nerve: P1, P2, P3) according to the median value of conduction velocity of each nerve; group M1 (n=35) and P1 (n=30): normal control group, group M2 (n=25) and P2 (n=30): below the median value of motor nerve conduction velocity in diabetes mellitus patients, group M3 (n=23) and P3 (n=29): above the median value of motor nerve conduction velocity in diabetes mellitus patients.
Results: There was no significant difference of area ratio between the each subgroups in both median and peroneal nerves. There was a significant difference of amplitude ratio between the M1 and M2 subgroups. There was a significant difference of amplitude ratio between the P1 and P2, P3 subgroups.
Conclusion: According to above results, the decrease of amplitude of compound muscle action potential along with the decrease of conduction velocity seems to be helpful in the electrophysiologic diagnosis of diabetic neuropathy.
First
Prev
