臨床神経45-1.indb
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1 59 Case of the Issue No. 9 carpal tunnel syndrome: CTS CTS CTS CTS nerve conduction study; NCS needle electromyography; nemg NCS carpal tunnel syndrome: CTS 1 CTS 4 CTS CTS CTS 1999 American Association of Electro diagnostic medicine AAEM American Academy of Neurology American Academy of Physical Medicine and Rehabilitation CTS NCS 3, CTS 6 CTS 1 CTS 2 2 CTS 6 CTS NCS motor nerve conduction study sensory nerve conduction study MCS SCS F
2 AAEM2002 CTS CTS 1 standard a cm b 2 guideline 3 option MCS SCS CTS 70 7 NCS 1 NCS 14 CTS / compound muscle action potential: CMAP / CMAP CMAP abductor policis brevis muscle: APB CMAP current spread 17 CTS 6 APB C8 Th1 ex. first dorsal interosseous: FDI C Tinel Phalen NCS 2 MCS SCS 2 CTS CTS
3 S1 S2 med ulnar rad CMAP compound muscle action potential SNAP sensory nerve action potential MNAP mixed nerve action potential S1 S2 27 NCS AAEM SCS standard CTS , MCS
4 NCS nemg ms m/s F ms LICS LICS D4CS 2.7 D4CS 2.2 potential CMAP 2 premotor potential 27 CMAP AAEM option 8 CMAP premotor potential SNAP CMAP premotor kg 8 kg Tinel Phalen NCS 3 2 CMAP nemg APB FDI 1 2 NCS CMAP SNAP CTS 2 24 APB CMAP CTS CMAP 25 CTS 105 APB CMAP 7 CMAP 26 CTS
5 NCS nemg ms m/s F ms NER NER NER NER D4CS NER D4CS 2.2 D1CS NER D1CS 1.6 PMCS NER PMCS 1.2 LICS LICS NER: no evoked response 1 CTS 4th finger method 26 CTS CTS CTS CTS 27 1 Atroshi I, Gummesson C, Johnsson R, et al: Precalence of carpal tunnel syndrome in a general population. JAMA 14: , McCartan B, Ashby E, Taylor EJ, et al: Carpal tunnel syndrome. Br J Hosp Med (Lond) 73: , American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 16: , American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 25: , Brain and Nerve 59: , : 65 84, uncommon nerve conduction study NCS 38: ,
6 64 40: 67 73, Preston DC, Logigian EL: Lumbrical and interossei recording in carpal tunnel syndrome. Muscle Nerve 15: , Felsenthal G, Spindler H: Palmar conduction time of median and ulnar nerves of normal subjects and patients with carpal tunnel syndrome. Am J Phys Med 58: , Robinson LR, Micklesen PJ, Wang L: Strategies for analyzing nerve conduction date: superiority of a summary index over single tests. Muscle Nerve 21: , Uncini A, Di Muzio A, Awad J, et al: Sensitivity of three median-to-ulnar compara tive tests in diagnosis of mild carpal tunnel syndrome. Muscle Nerve 16: , Carrol GJ: Comparison of median and radial nerve sensory latencies in the electrophysiological diagnosis of carpal tunnel syndrome. Electroencephalogr Clin Neurophysiol 68: , Oh SJ: Clinical Electromyography: Nerve Conduction Studies. 2nd ed, Lippincott Williams & Wilkins, Philadelphia Knack Pitfalls pp 80 85, Lesser EA, Venkatesh S, Preston DC, el al: Stimulation distal to the lesion in patients with carpal tunnel syndrome. Muscle Nerve 18: , J Clin Rehabil 13: , Werner RA, Andary M: Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 44: , Jackson DA, Clifford JC: Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys Med Rehabil 70 3 : , Takahashi N, Takahashi O, Ogawa S, et al: What is the origin of the premotor potential recorded from the second lumbrical? Muscle Nerve 34: , Masakado Y, Abe L, Kawakami M, et al: The origin of the premotor potential recorded from the second lumbrical. Electromyogr Clin Neurophysiol 48: 9 11, Masakado Y, Kodama M, Takahashi O, et al: The origin of the premotor potential recorded from the second lumbrical muscle in normal man. Clin Neurophysiol 122: , Kodama M, Sasao Y, Tochikura M, et al: Premotor potential study in carpal tunnel syndrome. Muscle Nerve 46: , Logigian EL, Busis NA, Berger AR, et al: Lumbrical sparing in carpal tunnel syndrome: anatomic, physiologic, and diagnostic implications. Neurology 37: , Boonyapist K, Katirji B, Shapiro BE, et al: Lumbrical and interossei recording in sever carpal tunnel syndrome. Muscle Nerve 25: , Kodama M, Tochikura M, Sasao Y, et al: What is the most sensitive test for diagnosing carpal tunnel syndrome? Tokai J Exp Clin Med 39: , : 41 46, Carpal tunnel syndrome YOSHIHISA MASAKADO, MICHI TOCHIKURA, MITSUHIKO KODAMA Department of Rehabilitation Medicine, Tokai University School of Medicine Key Words carpal tunnel syndrome, nerve conduction study, lumb-interossei method, 4th finger method, sensitivity
臨床神経 indd
164 41 3 CTS CTS Key Words : carpal tunnel syndrome, nerve conduction study, sensory nerve action potential CTS CTS 10 1 2 CTS 1 3 4 CTS 1 Tinel Phalen Tinel CTS 1 Phalen Phalen Phalen Phalen 2 1/3 : 1
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157 C6 T1 C8/T1 TOS true neurogenic TOS T1 C8 Key Words : brachial plexopathy, sensory nerve conduction studies, needle EMG, thoracic outlet syndrome, neuralgic amyotrophy 1 2 1 3 C5 T1 5 root trunk division
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