The electrodiagnostic approach to carpal tunnel syndrome

CTS is a clinically defined syndrome; however, there is value added by an evidence-based electrodiagnostic approach to (1) efficiently confirm the diagnosis (particularly before invasive interventions), (2) to identify neurogenic mimickers or superimposed processes that may influence the response to treatment, and (3) to stratify the degree of neurogenic injury to help the clinician make management decisions in conjunction with the severity of the clinical symptoms. The literature on the electrodiagnostic diagnosis of CTS is reviewed and an evidence based diagnostic algorithm is proposed. Confounders to CTS electrodiagnostic diagnosis are discussed (crossovers, peripheral neuropathy, and recurrent symptoms after surgical release).