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Carpal Tunnel Syndrome Message Board
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Old 02-13-2003, 01:53 PM   #1
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cbarkleyswenson HB User
Lightbulb Help me understand my diagnosis

Please tell me your opinion!
Went to a Diplomate of the American Board of Physical
Medicine and Rehabilitation doctor, D.O.
Here is his interpretation Verbatim: " Nerve conduction studies of the right Median and Ulna motor and sensory, Superficial Radical sensory and the Lateral Antebrachial Cutaneous nerves were performed at a skin temperature greater than 32 degrees Celsius. All test results were compared with standard laboratory reference values. All Ulnar, Superficial Radical and Antebrachial Cutaneous amplitude and latency values were within normal limits. The right Median SNAP and CMAP were severely prolonged with some reduction in amplitude. The median motor response was as well relatively prolonged when compared to the Ulnar motor response. The derived conduction velocity values were as well within normal limits.

Median and Ulnar F-waves were performed and compared to standard laboratory reference values. All responses were within normal limits

Right Median and Ulnar orthodromic conduction's were performed across 8cm transcarpal segments and compared known standard reference values. All Ulnar amplitude and latency values were within normal limits. The right Median response significantly prolonged with reduced amplitude. The never to nerve variation was also noted to be outside the normal acceptable range.

Needle electromyography of selected right upper extremity and paracervical muscles was performed using a 25mm disposable monopolar needle electrode. An abnormal amount of spontaneous activity in the form of positive sharp waves and fibrillation potentials were recorded from the right APB and Opponens. All other sampled muscles were normal. Several large amplitudes and polyphasic motor units were as well observed. The interference pattern appeared normal.

Conclusion: This is an ABNORMAL STUDY. The electrodiagnostic findings above are most consistent with a severe axonal Median neuropathy at the right wrist and resulting in acute and ongoing denervation with minimal evidence of neuronal reinnervation.

This electrodiagnostic evidence of a superimposed cervical radiculopathy affecting the right upper extremity

I would strongly recommend referral to a fellowship trained orthopedic hand surgeon for further evaluation and management of this patient.

Please tell me what you think of this diagnosis.

 
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