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Updated: Mar 25, 2026

Screening of Axonal Degeneration in Carpal Tunnel Syndrome Using Ultrasonography and Nerve Conduction Studies
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GEHS Neurophysiological Classification System for Patients with Carpal Tunnel Syndrome.

David G Greathouse1, Greg Ernst, John S Halle

  • 1Director, Clinical Electrophysiology Services, Texas Physical Therapy Specialists, New Braunfels, Texas.

U.S. Army Medical Department Journal
|February 14, 2016
PubMed
Summary

Carpal tunnel syndrome (CTS) diagnosis relies on electrophysiological tests like nerve conduction studies (NCS) and electromyography (EMG). This study compares two classification systems, Bland and GEHS, for grading CTS severity based on these tests.

Keywords:
carpal tunnel syndromemedian nervenerve conduction studies

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Area of Science:

  • Neuroscience
  • Clinical Electrophysiology
  • Neurology

Background:

  • Carpal tunnel syndrome (CTS) is a common nerve disorder affecting individuals with intensive hand use.
  • Electrophysiological testing, including nerve conduction studies (NCS) and electromyography (EMG), is the gold standard for diagnosing CTS.
  • These tests identify the affected nerve, location, and type of nerve damage (myelinopathy or axonopathy).

Observation:

  • Two neurophysiological classification systems for CTS are available: the Bland (2000) and GEHS (2012) systems.
  • The Bland system uses NCS findings but excludes EMG data.
  • The GEHS system incorporates both NCS and EMG findings for a comprehensive assessment.

Findings:

  • Case studies illustrate the application of both Bland and GEHS systems in patients with electrophysiological evidence of CTS.
  • The GEHS system provides a more detailed classification by including both NCS and EMG parameters.
  • The GEHS system can identify myelinopathy and/or axonopathy in CTS patients.

Implications:

  • The GEHS classification system offers a more detailed electrophysiological assessment for carpal tunnel syndrome.
  • Further research is needed to compare the psychometric properties and prognostic value of the Bland and GEHS systems.
  • Accurate classification aids in understanding and managing CTS.