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Sensibility testing in peripheral-nerve compression syndromes. An experimental study in humans
Summary
Threshold tests accurately detect peripheral nerve compression, showing gradual nerve function decline before motor strength loss. These tests correlate with symptoms and electrodiagnostics, aiding clinical evaluation.
Area of Science:
- Neurology
- Neuroscience
- Clinical Electrophysiology
Background:
- Peripheral nerve compression syndromes (PNCS) present diagnostic challenges.
- Accurate sensibility testing is crucial for timely diagnosis and management of PNCS.
Purpose of the Study:
- To investigate the efficacy of different sensory testing methods in detecting median nerve compression.
- To compare threshold tests with innervation density tests in reflecting nerve function changes.
Main Methods:
- Controlled external compression of the median nerve at the carpal tunnel in 12 volunteers.
- Monitoring using two-point discrimination, moving two-point discrimination, Semmes-Weinstein pressure monofilaments, and vibration tests.
- Continuous assessment of sensory and motor conduction, subjective sensations, and motor strength.
Main Results:
- Threshold tests (vibration, monofilaments) consistently showed gradual nerve function decline.
- Innervation density tests remained normal until near-complete sensory conduction loss.
- Decreased motor strength was a late finding, occurring after sensory changes.
Conclusions:
- Threshold tests of nerve sensibility accurately reflect nerve compression.
- These tests correlate well with clinical symptoms and electrodiagnostic findings.
- Threshold testing shows potential for clinical application in diagnosing PNCS.