Role of neurosensory testing in differential diagnosis of failed carpal tunnel syndrome

Abstract

Carpal tunnel syndrome is the most frequently encountered nerve compression.The diagnosis is based on a combination of subjective (history)and objective (physical examination and sensory testing)criteria.Interestingly,a positive history and electro-diagnostic study (EDS)often suffices to schedule surgery.In mild carpal tunnel syndrome it has been shown that 30%of symptomatic patients may have a normal EDS [1].In acute and chronic nerve compressions,simple tests of cutaneous pressure and vibratory threshold have been proven to be less reliable [2, 3].For example,Semmes-Weinstein (SW)nylon monofilaments only test one-point static touch threshold.Therefore,with the SWmonofilaments,mild nerve compressions will not be detected. © 2007 Springer-Verlag Berlin Heidelberg.