Yoohwan Kim | 2 Articles |
Background
Previous studies of radial nerve conduction study (NCS) did not present how to measure the length of the radial nerve across the elbow, and did not even mention how to manage the spiral course of the nerve. This study aimed to applicate the most reliable method to measure the length of the radial nerve during NCS. Methods Three points (A, B, and C) were determined along the relatively straight course of the radial nerve. The distance was measured using three different methods: L1) straight distance corresponding to the A-C distance, L2) sum of the distances corresponding to the A-B-C distance, L3) based on the L2, but the elbow is flexed at a 45° angle. We compared the three methods of distance measurement and the calculated nerve conduction velocities (V1, V2, and V3) in normal healthy subjects. Results 19 normal participants were enrolled. The mean value for method L1, L2 and L3 were 22.5 ± 1.8 cm, 24.0 ± 2.1 cm, and 23.2 ± 2.1 cm (p < 0.001). Calculated conduction velocities using those distance measurement methods as follows (p < 0.001): V1 (60.9 ± 2.7 m/s), V2 (64.6 ± 3.3 m/s), and V3 (63.4 ± 3.9 m/s). V2 was significantly greater than V1 and V3 (p < 0.001, p = 0.010, respectively). Conclusions The distance measurement using a stopover point near the lateral epicondyle between two stimulus points in position of a fully extended elbow with forearm pronation is the most appropriate posture for radial motor NCS.
![]()
Background
Median F-wave latencies are physiologically shorter than ulnar latencies, but they are often longer relative to ulnar latencies in carpal tunnel syndrome (CTS). This study aimed to investigate the value of absolute F-waves and relative latency changes compared to ulnar latencies in the diagnosis of CTS. Methods F-wave latencies of median and ulnar nerves in 339 hands from 339 patients with CTS and 60 hands from 60 control subjects were investigated. Mean F-wave minimal latencies of median and ulnar nerves were compared between groups. Patients were further divided into subgroups based on Canterbury grading and then analyzed using F-wave latency differences (FWLD) and F-wave ratio (FWR). Results Of 339 hands in the CTS group, 236 hands exhibited F-wave inversion based on the FWLD criterion and 277 hands had F-wave inversion based on the FWR criterion. F-wave inversion had a sensitivity of 81.7% using the FWR criterion to diagnose CTS. The mean FWLD and FWR were significantly greater in all patient subgroups compared to the control group (p < 0.001). In addition, mean FWLD and FWR showed significant correlations (r = –0.683 and r = 0.674, respectively, p < 0.001) with disease severity. Conclusions F-wave studies are effective supplementary diagnostic tools comparing to other standard electrophysiologic criteria for screening patients with CTS.
|