[Neurological examination methods of the hand]

Handsurgeons are normally more interested in clinical tests evaluating sensory and movement disorders of hand. Since these are often unprecise and require a cooperative (and intelligent) patient, neurologists and neurosurgeons prefer precise diagnostic procedures. For this reason they use electrophysiological techniques to evaluate and localize peripheral nerve lesions, i.e. electromyography, sensory and motor nerve conduction velocity and somatosensory-evoked potentials (SEP), by which most nerves of the arm and hand (median, ulnar and radial nerves including their major branches) can be easily assessed. Insufficient technique (submaximal stimulation, no temperature control, stimulation of a neighbouring nerve) and mis- or overinterpretation are sources of error, which can best be avoided when the diagnosis is made in context with the clinical picture--especially when the surgeon is familiar with electrophysiological techniques.