A new clinical scale to grade the impairment of median nerve in carpal tunnel syndrome

Clin Neurophysiol 121(7):6 (2010) PMID 20185361

Objective: In carpal tunnel syndrome (CTS) distribution of paresthesias is related to the degree of the nerve impairment. To improve the clinical ability in detecting the damage severity, we have introduced the criteria ''distribution of paresthesias'' in a previous clinical scale: the historical-objective scale (Hi-Ob). Methods: We evaluated 100 consecutive patients (40 bilateral CTS) to validate a five stages clinical scale: the Historical-objective-distribution based scale (Hi-Ob-Db). We compared the Hi-Ob-Db with a validated neurophysiological classification and with the Boston Carpal Tunnel Questionnaire (BCTQ). The BCTQ evaluates two domains, one assessing symptoms (SYMPT=patient-oriented symptom), and the other analysing ''functional status'' (FUNCT=patient-oriented function). Results: The positive correlation between the Hi-Ob-Db and neurophysiological findings (p<0.002, r:0.30). Conclusions: The Hi-Ob-Db is a clinical scale which correlates with the neurophysiological impairment of the median nerve and with patient-oriented findings in patients with CTS. Significance: The new scale may be useful in routine examination and for scientific purposes.

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