View source for NCS-MEDIAN NEUROPATHY (WRIST)

===== [[Summary Article|'''SUMMARY''']] =====
1. Sensory fibers are usually affected first. Rarely, motor axons are preferentially affected, due to focal compression of the recurrent branch or selective effects on fascicles within the nerve.
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<br/>2. The patient often does not localize the numbness to simply the median distribution but indicates the whole hand.
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<br/>3. Detection of slowing of median nerve conduction at the wrist is the primary goal of investigation. 
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<br/>4. 3 sensory studies (add the latency differences to obtain the Combined Sensory Index score):
<br/>- Comparison of median-ulnar conduction to the ring finger
<br/>- Comparison of median-radial conduction to the thumb
<br/>- Comparison of median-ulnar conduction to the palm (8cm distance)
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<br/>5. Motor conduction studies should be performed even if sensory studies are normal. Needle EMG is sometimes useful as well.


==Reference(s)==
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.]
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.]
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].

[[Category:NCS]]
[[Category:Neurology]]
[[Category:Medicine]]