综述腕管综合征中数字神经电位图的使用.docVIP

综述：腕管综合征中数字神经电位图的使用Conventional electrodiagnostic studies, including needle electromyography (EMG) and nerve conduction testing, have a proven and long established place in the diagnosis and treatment of disorders of nerve and muscle including carpal tunnel syndrome (CTS).1,2 Over the last two decades, other diagnostic devices have been developed to assess CTS. One such device is the Nervepace Digital Electroneurometer (NDE). Because of the differences between the NDE and more conventional electrodiagnostic techniques, in April 1992, the American Association of Electrodiagnostic Medicine (AAEM) undertook a literature review (published in 19975) to offer the AAEM’s opinion regarding what the current literature reveals with respect to the clinical utility of theNDE in the diagnosis and treatment of CTS.In September 2000, the authors were chargedwith updating the review. Several drafts of the reviewwere circulated among the authors until they believedthat this review accurately reflected the currentstate of the literature. The article was also circulatedamong members of the AAEM Practice IssueReview Panel for input, prior to review and approvalby the AAEM Board. No clinical tests or trials wereperformed by the AAEM; the AAEM’s opinion isbased solely on a review of the literature.?NERVEPACE DIGITAL ELECTRONEUROMETER?The NDE, designed by Rosier and Blair,12 is a compact battery-powered instrument that purports to measure the distal motor latency in peripheral nerves. Recording electrodes are placed over the hand muscles, and surface stimulation electrodes are placed distally on a peripheral nerve. Stimulation is achieved through use of a 20-V battery, which produces a variable output (from 0 V to 300 V) with a pulse duration of approximately 0.5 ms. Stimulator intensity is gradually increased until muscle contraction is observed.A liquid crystal diode (LCD) screen displays the delay numerically in milliseconds between the initiation of the impulse to the onset of m