Clinical trial NCT04619849: Electrophysiological Changes Based on the Palmaris Longus
Official title: Electrophysiological Changes in the Median Nerve in the Presence and Absence of the Palmaris Longus
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Palmaris Longus Muscle, Absence of
Carpal Tunnel Syndrome
EMG Syndrome
Keywords: carpal tunnel syndrome
palmaris longus
median nerve
carpal tunnel
Lead sponsor: Istanbul Medipol University Hospital
Sponsor class: OTHER
First posted: 2020-11-06
Enrollment: 100
Sex: ALL
Minimum age (years): 20
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: DIAGNOSTIC

Brief summary: One of the most important causes of carpal tunnel syndrome is increased pressure in the canal. With the loading of the palmaris longus at 20 degrees of wrist extension, the pressure within the canal increases more than the load exerted on other flexor tendons. Several studies have shown the association of carpal tunnel syndrome with the presence of palmaris longus. In this study, our aim is to investigate how the presence or absence of palmaris longus changes EMG measurements in the median nerve. Individuals with a diagnosis of carpal tunnel syndrome or entrapment neuropathy will be given the Schaffer test, a standardized test to test the presence of the palmaris longus muscle. The result will be noted, EMG examination will be requested and the electrophysiological properties of the median nerve will be recorded.

Detailed description: One of the most important causes of carpal tunnel syndrome(CTS) is the pressure increase in the canal. With the loading of the palmaris longus at 20 degrees of wrist extension, the pressure within the canal increases more than the load exerted on other flexor tendons. Several studies have shown the association of carpal tunnel syndrome with the presence of palmaris longus. Our aim in this study is to investigate how the presence or absence of the palmaris longus changes the EMG measurements in the median nerve. Individuals with a diagnosis of carpal tunnel syndrome or entrapment neuropathy will be given the Schaffer test, a standardized test to test the presence of the palmaris longus muscle. The result will be noted, EMG examination will be requested, and the electrophysiological properties of the median nerve will be recorded. If the Schaffer test that detects the presence of palmaris longus is negative, 4 different tests that will prove the absence of palmaris longus will be performed by the same practitioner. These 4 tests are Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's "two-finger sign" method. Routine median nerve conduction studies are valuable in CTS. Prolonged distal latency in motor and sensory nerves can be found in most cases of CTS. If routine studies are insufficient, more sensitive methods are needed. These; Comparison of mixed latencies in the wrist recording of the sensory responses of the median and ulnar nerves with palmar stimulation, median and ulnar sensory latencies with orthodromic or antidromic recording from the 4th finger, median and ulnar motor latencies with recording from the second lumbrical and second interosseous muscle, median and radial sensory latencies with thumb recording It is based on determining the compression point by centrifugation method by performing segmental sensory nerve conduction examination.

Eligibility criteria: Inclusion Criteria:

* Applying to the electrophysiology laboratory for an EMG examination for entrapment neuropathy. The examination should be requested by a doctor.

Exclusion Criteria:

* Having a disease affecting the orthopedic, neurological or rheumatological skeletal and neurological system;
* Those who do physical activity so heavy that they cause muscle pain or neurological damage;
* Those who have an operation in the area to be evaluated

Primary outcomes:
measure: Median Nerve Conduction Velocity
timeFrame: 1st day
measure: Median Nerve Peak Latency
timeFrame: 1st day
Secondary outcomes:
measure: Ulnar Nerve Conduction Velocity
timeFrame: 1st day
measure: Ulnar Nerve Peak Latency
timeFrame: 1st day
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Istanbul Medipol University
state: Beykoz
Study officials:
affiliation: Medipol University
name: Mustafa Şahin, PhD
role: STUDY_CHAIR
References: