Fatoş KÜRŞAD, İbrahim ÖZTURA, Ahmet GENÇ

Karpal tünel sendromu tanısında subjektif yakınmaların kantitatif olarak kullanılabilirliği

nel sendromu (KTS) en sık görülen tuzak nöropati olması ve tanısında elektrofizyolojik incelemenin kullanılmasından dolayı, elektromiyografı (EMG) laboratuarlarına gönderilen hastalar içinde en büyük grubu oluşturmaktadır. Bu çalışmada, KTS öntanısı ile kliniğimizin EMG laboratuvarına gönderilen hastaların sübjektif yakınmalarının Boston Karpal Tünel Sendromu Anketi (BKTSA) kullanılarak skorlanması, bu skorlar ile elektrofizyolojik bulgular arasındaki ilişkinin değerlendirilmesi hedeflenmiştir. Gereç ve yöntem: Çalışmaya Haziran-Eylül döneminde anabilim dalımızın EMG laboratuvarına KTS ön tanısı ile gönderilen 76 hasta ve 30 sağlıklı gönüllü alındı ve elektrofizyolojik incelemeler 212 elde yapıldı. Bulgular: Yetmiş altı hastanın 30'unda elektrofizyolojik olarak KTS saptandı. Elektrofizyolojik olarak KTS saptanan ve saptanmayan grupların sübjektif yakınmalarını değerlendiren BKTSA sonuçları arasında anlamlı fark olduğu görüldü (p%50 spesifiteye sahip olduğu görülmüştür. Sonuç: KTS'de sübjektif yakınmaların değerlendirildiği BKTSA ile elektrofizyolojik bulgular arasında kuvvetli bir korelasyon mevcuttur. Elektrofizyolojik inceleme öncesi bu kısa ve güvenilir anketin uygulanması ile doğru tanı oranı arttırılarak zamansal ve ekonomik kayıplar azaltılabilir.

Anahtar Kelimeler:

Sinir sıkışması sendromları, Karpal tünel sendromu, Elektrofizyoloji, Değerlendirme çalışmaları, Anketler

Quantitative employment of subjective complaints in carpal tunnel syndrome diagnosis

KTS, BKTSA, EMG, elektrofizyoloji, tuzak nöropati SUMMARY Objective: Carpal tunnel syndrome (CTS) constitutes the largest group of the patients referred to electromyography laboratories (EMG), since it is the most frequent entrapment neuropathy and electrophysiologic investigation is being employed for its diagnosis .In this study, we are aiming to decrease the number of the electrophysiological investigation demands by application of Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ). Material and method: 76 patients referred to Neurology Department of Dokuz Eylül University Medical: Faculty with suspect CTS and 30 healthy volunteers were included in our study between June October 2003. Electrophysiologic investigations were done 212 hands totally. Results: CTS was detected electrophysiologically in 30 patients of 76. A significant difference (p<0,05) was detected between the BCTSQ scores assessing the subjective complaints of electrophysiologically CTS(+) and CTS (-) groups. Symptom score summs as 29.5 and bigger numbers has %60 sensivity and %60 specificity for CTS prediagnosis; functional score summs as 16.5 and bigger numbers has %63 sensivity and >%50 specificity for the CTS prediagnosis. Conclusion: There is a strong correlation between the BCTSQ scores assessing the subjective scores and electrophysiologic findings for CTS. Prior to the electro- phsiologic investigation, application of this simple and reliable questionnaire reduces the economic and time losses by increasing the rate of true diagnosis.

Keywords:

Nerve Compression Syndromes, Carpal Tunnel Syndrome, Electrophysiology, Evaluation Studies, Questionnaires,

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