300 Section - Ten Years of Insights: Electrodiagnostic Findings for Carpal Tunnel Syndrome in Thailand

Carpal tunnel syndrome (CTS) is the most common form of entrapment neuropathy. The electrodiagnostic (EDx) study is the preferred investigative method; however, routine nerve conduction studies (NCS) often lack the sensitivity needed for accurate detection. The combined sensory index (CSI) improves detection rates but remains less understood and underutilized. Presenting the results of the CSI and its detection rate could enhance awareness and improve the effectiveness of EDx studies in diagnosing CTS.

Design:

In a study conducted at Thammasat University Hospital, Thailand, from 2012 to 2023, data were collected from 220 CTS patients.

Results:

The findings revealed that CTS predominantly affected female (83.64%), with an average age of 53 years and a BMI of 25.63 kg/m². Among the patients, 76.26% experienced CTS in both hands, with a mean symptom duration of 11 months. The primary sensory symptoms reported included numbness (80.91%) and pain (35.45%) in the hands. Clinical signs such as Tinel’s sign and the Carpal Compression Test were observed in 57.73% and 37.73% of patients, respectively. EDx studies were performed for diagnostic purposes in 59.09% of the patients. Among the 130 patients (representing 260 hands) who underwent EDx studies, 8.85% showed no EDx evidence of CTS. In contrast, 23.85%, 32.31%, and 24.23% exhibited mild, moderate, and severe degrees of CTS, respectively. The CSI was conducted on 38 hands (14.62%), successfully identifying CTS in 13 of 19 (68.42%) hands that had a distal sensory peak latency of less than 4.0 msec on routine NCS.

Conclusion: Patients with CTS are typically female, middle-aged, and overweight, presenting symptoms like hand numbness and pain. Diagnosis often relies on clinical evaluations, with only half confirmed by electrodiagnostic testing. Utilizing the CSI can improve detection, diagnostic accuracy, and enhancing patient outcomes.