수근관증후군 진단에서 말단 잠복기 지수의 유용성
Usefulness of Terminal Latency Index in Diagnosis of Carpal Tunnel Syndrome
권석범, 정산, 황성희, 신준현, 김우경, 이상무, 권기한,
소속 상세정보
권석범 ( Kwon Seok-Beom )
한림대학교 의과대학 신경과학교실
정산 ( Jung San )
한림대학교 의과대학 신경과학교실
황성희 ( Hwang Sung-Hee )
한림대학교 의과대학 신경과학교실
신준현 ( Shin Joon-Hyun )
한림대학교 의과대학 신경과학교실
김우경 ( Kim Woo-Kyung )
한림대학교 의과대학 신경과학교실
이상무 ( Lee Sang-Moo )
한림대학교 의과대학 신경과학교실
권기한 ( Kwon Ki-Han )
한림대학교 의과대학 신경과학교실
KMID : 0860920060080020085
Abstract
Objectives: The electrophysiology of the carpal tunnel syndrome (CTS) has been extensively studied, but no single measure or combination of measures has adequate diagnostic sensitivity and specificity. The terminal latency index (TLI) is a calculated value that adjusts the distal motor latency for the terminal distance and the proximal motor nerve conduction velocity (NCV). We undertook this study to assess the validity of the median nerve TLI in evaluation of CTS.
Methods: We prospectively evaluated 67 consecutive clinical CTS patients (104 hands) to assess the sensitivity of the median nerve TLI for the diagnosis of CTS. Control data of nerve conduction study (NCS) parameters were obtained from 21 healthy persons (38 hands).
Results: The mean TLI was 0.24±0.06 in the CTS group and 0.37±0.03 in the control group (P<0.05).
The calculated lower limit of normal TLI from the control group (mean-2SD) was 0.31. The sensitivity of the TLI for the diagnosis of CTS was 83.7%. Twenty hands (19%) had a normal III-W (from middle finger to wrist) SNCV, fifteen hands (14%) had a normal median TL (median motor terminal latency), 14 hands (13%) had a normal P-W (from palm to wrist) SNCV, and 9 hands (9%) had a normal ML-UL (median-ulnar sensory conduction difference) with an abnormal TLI. The TLI was the only abnormal electrophysiological parameter in seven cases (7%) from the CTS group.
Conclusion: Our study showed the TLI is a useful, sensitive electrophysiologic measure for the presence of CTS.
키워드
Carpal tunnel syndrome;Terminal latency index;Nerve conduction study;Sensitivity
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