Effect of Provocative Tests on Electrodiagnosis of Carpal Tunnel Syndrome

Abstract

SUMMARY E lectrodiagnosis is the gold standard tool in diagnosis of carpal tunnel syndrome, yet some patients with clinically diagnosed carpal tunnel syndrome are found to have a normal nerve conduction results, so recent studies are concerned with using provocative tests before performing the nerve conduction study to help in better diagnosis and better correlation between clinical symptoms and electrophysiological findings. Generally, results of the studies are controversial, but in this study, which was cross sectional case control study, on hundred hands of patients clinically diagnosed as carpal tunnel syndrome, and control group of fifty hands of healthy volunteer individuals with no clinical findings concerning carpal tunnel syndrome symptoms and signs, nerve conduction study on median nerve was done sensory and motor amplitude and distal latency was recorded before and after one minute provocation using Phalen's test. Results revealed that there were significant changes in some of the electrodiagnostic parameters, after one minute provocation using phalen test, such as motor amplitude, sensory and motor distal latencies, and no significant difference regarding sensory amplitude (in patients group compared to control group), and when divided into two groups according to positive and normal electrodiagnostic findings, there was no value added after the phalen's test with the group of normal electrodiagnostic