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Median Segmental Sensory Study
Hi all,
I like the median D2 or D3 segmental sensory study for the CTS evaluation. I usually measure 14cm to the wrist and 7cm to the palm. It's the only way that I'm aware of to distinguish sensory axon loss from sensory conduction block across the wrist. It also seems to be very sensitive in detecting focal slowing that was diluted over the larger distance. However, it can be technically challenging to produce a flat baseline, especially in the palm. And there is often significant variability in onset latencies with repeated attempts, so I will typically take the average 4-6 responses at each site before looking at the segmental conduction velocities. My question for this group: Why not use the peak latency difference between wrist and palm instead of conduction velocity? It would have to be standardized for distance of course but most hands fit the 7/14cm montage. Does anyone use peak latency difference or know of reference values for this?
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