Zur elektrophysiologischen Diagnostik des Karpaltunnelsyndroms: Eigene Untersuchungen bei 124 Kontrollpersonen und eine Literaturübersicht

Zusammenfassung

Das Karpaltunnelsyndrom (KTS) ist das häufigste Engpasssyndrom eines peripheren Nerven und einer Behandlung gut zugänglich. Die elektrodiagnostischen Methoden erlauben eine sichere und frühzeitige Erkennung des KTS, ermöglichen Aussagen zum Schweregrad der Nervenläsion, dienen der postoperativen Verlaufskontrolle und ermöglichen eine differenzialdiagnostische Abgrenzung von anderen neurogenen Erkrankungen. Dabei haben sich die Messung der distal-motorischen Latenz des N. medianus im Vergleich zu der im N. ulnaris, die Bestimmung der sensiblen Latenzen bzw. sensiblen Nervenleitgeschwindigkeit im distalen Abschnitt des N. medianus verglichen mit denen im N. ulnaris und N. radialis superficialis sowie die Messung der sensiblen Latenzen im Handgelenksbereich verglichen mit denen im Abschnitt Hohlhand-Finger, als diagnostisch sinnvoll und zuverlässig durchgesetzt. Durch eigene Untersuchungen bei 124 gesunden Probanden ermittelten wir Grenzwerte für die oben aufgezählten elektrophysiologischen Parameter, präsentieren anhand von ausgesuchten Fallbeispielen Sonderformen des KTS und geben eine zusammenfassende Literaturübersicht zum gegenwärtigen Stand der Elektrodiagnostik des Karpaltunnelsyndroms.

Abstract

The carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome and is well treatable. Electrophysiological tests allow an early and reliable recognition of a CTS, provide information on the severity of the nerve lesion, are useful for follow-up investigations after surgical treatment and play an important role in the differentiation from other neurogenic diseases. Among various tests which have been proposed for the electrophysiological assessment of a CTS, the following ones have been found to be useful and reliable: a comparison of the distal motor latencies of the median and ulnar nerve, a median-ulnar and median-radial comparison with respect to the sensory nerve latencies and sensory nerve conduction velocities, and the assessment of differences of sensory latencies between the wrist-palm and the palm-digit segments of the median nerve. In the present article. We demonstrate normal values for the above mentioned electrophysiological tests which were determined by studying the hands of 124 healthy volunteers. We also give clinical and electrophysiological examples for unusual forms of a CTS and present a literature review of the electrodiagnostics of the carpal tunnel syndrome.

Key words

Carpal tunnel syndrome - Electrodiagnosis - Nerve conduction studies

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