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Correlation between two-point discrimination and median nerve sensory response.
E S Marlowe1, F J Bonner, A R Berkowitz
1Department of Physical Medicine and Rehabilitation, Graduate Hospital, Philadelphia, Pennsylvania, USA.
Muscle & Nerve
|August 24, 1999
Summary
Static two-point discrimination (2PD) is often used for carpal tunnel syndrome (CTS), but this study found it poorly predicts median nerve conduction findings. Abnormal 2PD may correlate with latency, but negative results offer little diagnostic value.
Area of Science:
- Neurology
- Orthopedics
- Hand Surgery
Background:
- Static two-point discrimination (2PD) is a clinical tool for assessing median neuropathy in carpal tunnel syndrome (CTS).
- The correlation between 2PD findings and objective median nerve sensory conduction studies is not well-established.
- Accurate assessment is crucial for effective CTS management.
Purpose of the Study:
- To determine the correlation between static 2PD measurements and median nerve sensory conduction parameters in patients with suspected CTS.
- To evaluate the clinical utility of 2PD in predicting electrodiagnostic findings.
- To inform diagnostic practices for CTS.
Main Methods:
- Median sensory nerve action potential parameters were recorded from the first and third digits of 83 hands.
- Static 2PD was performed in a standardized manner by hand surgeons.
- Electrodiagnostic results were compared with 2PD measurements.
Main Results:
- A general lack of correlation was observed between most electrodiagnostic parameters and 2PD.
- Peak and onset latencies to the thumb showed some correlation with 2PD.
- Abnormal 2PD to the thumb was found to be useful, but normal 2PD provided no additional diagnostic information.
Conclusions:
- Static 2PD may show some correlation with median nerve sensory conduction latencies, particularly to the thumb.
- Overall, static 2PD does not reliably predict the findings of sensory nerve conduction examinations in CTS patients.
- Clinical decisions should consider both 2PD and electrodiagnostic findings for comprehensive CTS assessment.