TUNNEL SYNDROME Nerve Conduction Study腕管综合征的神经传导研究课件.pptVIP

Take home message! In carpal tunnel syndrome there will be a longer latency between the wrist and the finger/thenar eminence but NOT between the elbow and the wrist The ulnar nerve will not be effected in carpal tunnel syndrome because it does not pass through the carpal tunnel CARPAL TUNNEL SYNDROMENerve Conduction Study Katie Doney – kdoney@.au Motor Pathways Ventral Horn CNS Motor Neuron Muscle Motor Pathways Possible places of dysfunction CNS EEGElectroencephalography PETPositron Emission Tomography fMRIFunctional Magnetic Resonance Imaging Motor Pathways Possible places of dysfunction 2. Muscle Needle EMG Electromyography CNS EEGElectroencephalography PETPositron Emission Tomography fMRIFunctional Magnetic Resonance Imaging Motor Pathways Possible places of dysfunction 2. Muscle Needle EMG Electromyography CNS EEGElectroencephalography PETPositron Emission Tomography fMRIFunctional Magnetic Resonance Imaging 3. Peripheral Nerve Nerve  conduction study Peripheral Nerve Made up of: Sensory nerves Motor nerves Myelin Glial cells MEDIAN ULNAR Median Nerve Pathologyin Carpal Tunnel Syndrome Compression of the median nerve results in Demyelination Axonal degeneration Decreased blood supply These manifest as: - Numbness - Pain - Parasthesiae - Weakness - Problems with fine manipulative skills Nerve Conduction Study Stimulate nerve and record outcome. 2 main types 1. Motor (record compound muscle action potential) 2. Sensory (record compound sensory action potential) -Orthodromic (stimulate at finger, record on elbow/wrist) -Antidromic (stimulate at elbow/wrist, record on finger) -Radial-median (stimulate at wrist, record on thumb) -Palmar (stimulate at palm, record on elbow/wrist) Most sensitive Least sensitive Changes to CMAP in Carpal Tunnel Syndrome Latency: Normal 4.9 ms Amplitude: Normal ≥ 5 mV Shape: Normal curve Time Response amplit