Does direct measurement of forearm mixed nerve conduction velocity reflect actual nerve conduction velocity through the carpal tunnel?
OBJECTIVES: The purpose of this study was to determine whether forearm (wrist-elbow) mixed nerve conduction velocity (W-Emix) represents the actual nerve conduction velocity (CV) of nerve fibers passing through the carpal tunnel. BACKGROUND: W-Emix is presumed to reflect the actual forearm CV through the carpal tunnel. However, it has been argued that W-Emix chiefly originates from the nerve fibers passing outside the carpal tunnel. Therefore, the direct measurement of W-Emix cannot be used to assess retrograde axonal atrophy in carpal tunnel syndrome (CTS). SUBJECTS AND METHODS: Thirty patients with clinical signs and symptoms of CTS were recruited and the diagnosis was confirmed with standard electrodiagnosis. Fifty age-matched volunteers served as control. Recording electrodes were placed over the elbow and index finger for mixed nerve and sensory nerve conduction studies, respectively. Stimulation was applied at the palm and wrist for the measurement of mixed nerve wrist-palm CV (W
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