臨床神経 indd

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1 CTS CTS Key Words : carpal tunnel syndrome, nerve conduction study, sensory nerve action potential CTS CTS CTS CTS 1 Tinel Phalen Tinel CTS 1 Phalen Phalen Phalen Phalen 2 1/3 : 1 2 All-median hand 4 5 CTS 1 5 CTS 3 CTS 4 Guyon CTS Guyon 5 CTS Guyon

2 2013. Guyon CTS median neuropathy at the wrist CTS median neuropathy at the wrist CTS CTS PMP22 HNPP CTS 1 APB CMAP 2 CMAP 165 CMAP CMAP CTS CTS 6 F CTS F F 2 CTS CTS

3 CTS SNAP 1 SNAP SNAP 0.5 ms SNAP bactrian sign SNAP, SNAP Onset latency 3 1 peak latency cm 0.4 ms median SNAP radial SNAP 0.5

4 Pooled sensitivity AAEM A 85 B 4 85 C 74 D 71 E 69 F 1 65 G 65 H 63 I terminal latency index TLI 62 J ms 4 SNAP CTS 7 / 2L IO CMAP 4 2 CMAP 10 cm 0.5 ms CTS CMAP SNAP SNAP CTS CMAP CTS 8 CTS Kimura CTS 7 2 cm 9 terminal index terminal index TI / TI CTS 10 CTS 1 8 9

5 gold standard CTS gold standard gold standard Guyon Guyon CTS CTS Guyon Yemisci CTS CTS 10 Mondelli CTS 11 CTS CTS Guyon CTS CTS Guyon 5 CTS 1 5 CTS Tinel Likelihood Ratio /1 1 / CTS 1 2 CTS CTS

6 CTS CTS 3 4 CTS CTS 2 CTS 7 1 CTS F CTS 2 CTS 2 CTS 13 1 CTS 3 1 CTS 4 CTS

7 170 4 Guyon CTS CTS CTS CTS CTS CMAP SNAP CTS 2 16 CTS double crush syndrome CTS CTS CTS APB 41 3 CTS CTS Wee CTS 17 APB CTS CTS 1 Bland JD: Carpal tunnel syndrome. BMJ 335: , Werner R, Armstrong TJ, Bir C, et al: Intracarpal canal pressures: the role of finger, hand, wrist and forearm position. Clinical Biomechanics 12: 44 51, Caliandro P, La Torre G, Aprile I, et al: Distribution of paresthesias in Carpal Tunnel Syndrome reflects the degree of nerve damage at wrist. Clin Neurophysiol 117: , Zanette G, Cacciatori C, Tamburin S: Central sensitization in carpal tunnel syndrome with extraterritorial spread of sensory symptoms. Pain 148: , Ginanneschi F, Filippou G, Reale F, et al: Ultrasonographic and functional changes of the ulnar nerve at Guyon s canal after carpal tunnel release. Clin Neurophysiol 121: , Chang MH, Lee YC, Hsieh PF: The role of forearm mixed nerve conduction study in the evaluation of proximal conduction slowing in carpal tunnel syndrome. Clin Neurophysiol 119: , Kimura J: The carpal tunnel syndrome: localization of conduction abnormalities within the distal segment of the median nerve. Brain 102: , Jablecki CK, Andary MT, Floeter MK, et al: Practice parameter: Electrodiagnostic studies in carpal tunnel syndrome. Report of

8 2013. the American Association of Electrodiagnostic Medicine, American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation. Neurology 58: , Yemisci OU, Yalbuzdag SA, Cosar SN, et al: Ulnar nerve conduction abnormalities in carpal tunnel syndrome. Muscle Nerve 44: , Mondelli M, Ginanneschi F, Rossi A: Evidence of improvement in distal conduction of ulnar nerve sensory fibers after carpal tunnel release. Neurosurgery 65: ; discussion 701, Nodera H, Herrmann DN, Holloway RG, et al: A Bayesian argument against rigid cut-offs in electrodiagnosis of median 171 neuropathy at the wrist. Neurology 60: , Dorfman LJ, Robinson LR: AAEM minimonograph #47: normative data in electrodiagnostic medicine. ff. Muscle Nerve 20: 4 14, Werner RA, Andary M: Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 44: , Robinson L, Kliot M: Stop using arbitrary grading schemes in carpal tunnel syndrome. Muscle Nerve 37: 804, Gnatz SM, Conway RR: The role of needle electromyography in the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 22: , Wee AS: Needle electromyography in carpal tunnel syndrome. Electromyogr Clin Neurophysiol 42: , 2002.

臨床神経45-1.indb

臨床神経45-1.indb 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 45 65 1 3 2 CTS CTS 1999 American

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