Electrophysiological findings in entrapment of the median nerve at wrist and elbow

In 117 consecutive patients with carpal tunnel syndrome and 11 patients with a compression syndrome of the median nerve at elbow, motor and sensory conduction along the median and ulnar nerves and quantitative electromyography were compared with findings in 190 normal controls of the same age. In 25% of patients with carpal tunnel syndrome in whom motor conduction and EMG were normal, the lesion was located from abnormalities in sensory conduction. The fact that conduction along the same fibres was moderately slowed from digit to palm, severely slowed across the flexor retinaculum, and normal from wrist to elbow indicates that slowing was due to demyelination at the site of compression. Fifteen per cent of the patients with carpal tunnel syndrome had clinical and electrophysiological signs of ulnar involvement. In the other patients conduction along the ulnar nerve was as in 100 normal controls. Compression at the elbow was located by electromyographical findings rather than by abnormalities in conduction.