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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(1):60-67.
Electrodiagnostic Study of Retrograde Degeneration in Carpal Tunnel Syndrome.
Ko, Young Jin , Kim, Hye Won , Choe, Su Jeong , Suh, Sun Sook , Kang, Sae Yoon
Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea.
수근관 증후군에서 정중신경의 역행성 변성에 대한 전기진단학적 연구
고영진, 김혜원, 최수정, 서선숙, 강세윤
가톨릭대학교 의과대학 재활의학교실

We investigated the useful electrodiagnostic indicators and the extent of retrograde degeneration (RD) in carpal tunnel syndrome (CTS).

We measured median mixed nerve action potentials (MMNAP) in 26 CTS and 37 normal hands by recording at the elbow and stimulating 0, 3, 6 and 9 cm proximal to the distal wrist crease. The 3 MMNAP parameters such as amplitude, latency and conduction velocity were compared between CTS and control group. The most useful indicator was compared between subgroups of CTS (mild and severe) and control group.

The amplitudes of all MMNAPs in CTS group, except stimulating 9 cm proximal to the wrist (MA9), were significantly smaller than those in control group (p<0.05). MA9 in severe CTS subgroup, not mild subgroup, was significantly smaller than that in control group (p<0.05). CTS and control group were not significantly different in the MMNAP latencies, except stimulating 9 cm proximal to the wrist (p<0.05), and in the MMNAP conduction velocity, except stimulating in 0 cm to 3 cm segment proximal to the wrist.

The amplitude of MMNAP in forearm can be the most useful indicator of RD in CTS, and the conduction velocity, a less useful indicator. We believe that RD progresses as the severity of CTS increases, and dose beyond 9 cm proximal to the distal wrist crease.

Key Words: Carpal tunnel syndrome, Retrograde degeneration, Median mixed nerve action potential


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