ABSTRACT
OBJECTIVE: To delineate H-reflex parameters and specify the diagnostic accuracy measures of thenar muscle H-reflex in Fibromyalgia (FM). METHODS: The study was a cross sectional study performed on 30 subjects with FM and 30 healthy volunteers in two major referral hospitals. We recorded the number of obtainable thenar H-reflexes and their minimum latency, threshold and amplitude in each group. RESULTS: There was a significantly more chance to elicit the H-reflex in patients with FM. H reflex threshold and minimum latency were lower in FM group but no significant difference was shown for H wave amplitude. According to our study, thenar H-reflex has 46.7% sensitivity, 86.7% specificity and 66.7% diagnostic accuracy to detect FM. It also has moderate predictive values and positive likelihood ratio but low negative likelihood ratio. CONCLUSION: Higher rate of thenar muscle H-reflex in fibromyalgia can be interpreted as a confirmatory finding to central sensitization theory for this disorder. Obtaining H-reflex from thenar muscles could be a helpful diagnostic tool for fibromyalgia that increases the confidence in diagnosis. Although it is a weak tool for screening because of low sensitivity, it has a relatively high specificity.
Subject(s)
Fibromyalgia/physiopathology , H-Reflex , Muscle, Skeletal/physiopathology , Thumb/physiopathology , Adult , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Male , Reproducibility of ResultsABSTRACT
INTRODUCTION & OBJECTIVE: Nerve conduction study is the most sensitive test for diagnosis of carpal tunnel syndrome (CTS). This test is normal in some patients with mild CTS. Median nerve conduction study evaluation after a provocative test (e.g. wrist flexion) may be helpful for diagnosis of mild CTS. This study aimed to determine the effect of wrist flexion on median nerve conduction in patients suspected to CTS and in healthy subjects. MATERIALS & METHODS: In this case-control study, 20 patients (20 hands) with clinical signs of CTS and normal routine electrodiagnosis test results and 20 healthy subjects were investigated. Measured parameters included: median nerve distal sensory latency (DSL), nerve conduction velocity (NCV) across wrist, compound nerve action potential (CNAP), distal motor latency (DML) and compound muscle action potential amplitude CAMPAMP). The above noted parameters were measured before and after 5 minutes of full wrist flexion. Data were analyzed using paired T-test. RESULTS: Distal Sensory Latency increment and NCV decrimental after 5 minutes of wrist flexion in the patients group were statistically significant (p > 0.05). The same parameters did not show significant incremental or detrimental changes in the control group. CONCLUSION: Median nerve DSL and NCV measurement after 5 minutes of wrist flexion may be helpful in determining more sensitive parameters in the electrodiagnosis of CTS.
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Carpal Tunnel Syndrome/physiopathology , Electrodiagnosis/methods , Median Nerve/physiopathology , Wrist Joint/physiopathology , Action Potentials/physiology , Adult , Case-Control Studies , Female , Humans , Male , Neural Conduction/physiology , Physical Stimulation/methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
INTRODUCTION AND OBJECTIVE: Nerve conduction study is the most sensitive test for diagnosis of carpal tunnel syndrome (CTS). This test is normal in some patients with mild CTS. Median nerve conduction study evaluation after a provocative test (e.g. wrist flexion) may be helpful for diagnosis of mild CTS. This study aimed to determine the effect of wrist flexion on median nerve conduction in patients suspected to CTS and in healthy subjects. MATERIALS AND METHODS: In this case-control study, 20 patients (20 hands) with clinical signs of CTS and normal routine electrodiagnosis test results and 20 healthy subjects were investigated. Measured parameters included: median nerve distal sensory latency (DSL), nerve conduction velocity (NCV) across wrist, compound nerve action potential (CNAP), distal motor latency (DML) and compound muscle action potential amplitude (CAMPAMP). The above noted parameters were measured before and after 5min of full wrist flexion. Data were analyzed using paired T-test. RESULTS: Distal sensory latency increment and NCV decrimental after 5 min of wrist flexion in the patients group were statistically significant (p<0.01). The same parameters did not show significant incremental or detrimental changes in the control group. CONCLUSION: Median nerve DSL and NCV measurement after 5 min of wrist flexion may be helpful in determining more sensitive parameters in the electrodiagnosis of CTS.
