Electrophysiological Assessment and Nerve Function in NTOS

Chapter

Abstract

Electro-diagnosis of NTOS has been challenging for several years, and conventional needle electrode and nerve conduction velocity techniques have proven disappointing. Currently, newer techniques using cervical root stimulation and measurements of medial antebrachial cutaneous nerve function appear to provide far improved clinical correlations for presence of NTOS, and should be included in any electro-diagnostic evaluation. Traditional approaches such as somatosensory evoked potentials, stimulation at Erb’s point, and F-wave determinations have been discredited, and provide little substantive information.

Keywords

Neuropathy Vasculitis Myopathy Radiculopathy Plexopathy 

References

  1. 1.
    Roos DB. Thoracic outlet syndrome is under-diagnosed. Muscle Nerve. 1999;22:126–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Gilliatt RW, LeQuesne PM, Logue V, Sumner AJ. Wasting of the hand associated with a cervical rib or band. J Neurol Neurosurg Psychiatry. 1970;33:615–24.PubMedCrossRefGoogle Scholar
  3. 3.
    Gilliatt RW, Williston RG, Dietz V, Williams IR. Peripheral nerve conduction in patients with a cervical rib or band. Ann Neurol. 1978;4:124–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Wulff CH, Gilliatt RW. F waves in patients with hand wasting caused by a cervical rib or band. Muscle Nerve. 1979;2:452–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Yiannikas C, Walsh JC. Somatosensory evoked ­potentials in the diagnosis of thoracic outlet syndrome. J Neurol Neurosurg Psychiatry. 1983;46:234–40.PubMedCrossRefGoogle Scholar
  6. 6.
    Veilleux M, Stevens JC, Campbell JK. Value of somatosensory evoked potentials in the diagnosis of thoracic outlet syndrome. Muscle Nerve. 1986;9:655.Google Scholar
  7. 7.
    Aminoff MJ, Olney RK, Parry GJ, Raskin NJ. Relative utility of different electrophysiologic techniques in the evaluation of brachial plexopathies. Neurology. 1988;38:546–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Cherington M. Ulnar conduction velocity in thoracic outlet syndrome. N Engl J Med. 1976;294:1185.PubMedGoogle Scholar
  9. 9.
    Wilbourn AJ, Lederman RJ. Evidence for conduction delay in thoracic outlet syndrome is challenged. N Engl J Med. 1984;310:1052–3.PubMedCrossRefGoogle Scholar
  10. 10.
    Smith T, Toyaberg W. Diagnosis of thoracic outlet syndrome. Arch Neurol. 1987;44:1161–3.PubMedCrossRefGoogle Scholar
  11. 11.
    Veilleux M, Stevens JC, Campbell JK. Somatosensory evoked potentials: lack of value for diagnosis of thoracic outlet syndrome. Muscle Nerve. 1988;11:571–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Wilbourn AJ. Thoracic outlet syndrome: a plea for conservatism. Neurosurg Clin N Am. 1991;2:235–45.PubMedGoogle Scholar
  13. 13.
    Cherington M, Happer I, Machanic B, Parry L. Surgery for thoracic outlet syndrome may be hazardous to your health. Muscle Nerve. 1986;9:632–4.PubMedCrossRefGoogle Scholar
  14. 14.
    Nord K, et al. Evaluation of thoracic outlet syndrome diagnostic maneuvers in carpal tunnel syndrome patients. Rev Neurol Dis. 2005;2:199–200.Google Scholar
  15. 15.
    MacLean IC, Taylor RS. Nerve root stimulation to evaluate brachial plexus conduction. Abstracts of communications of the fifth international congress of electromyography. Rochester, Mn. 1975. p. 47.Google Scholar
  16. 16.
    Livingstone EF, DeLisa JA, Halar EM. Electro­diagnostic values through the thoracic outlet using C8 root needle studies, F-waves, and cervical somatosensory evoked potentials. Arch Phys Med Rehabil. 1984;65:726–30.PubMedGoogle Scholar
  17. 17.
    Goodgold J, Eberstein A. Electrodiagnosis of neuromuscular diseases. Baltimore: Williams & Wilkins; 1983. p. 217.Google Scholar
  18. 18.
    Kimura J. Electrodiagnosis in diseases of nerve and muscle. Philadelphia: FA Davis; 1983. p. 119–22.Google Scholar
  19. 19.
    Berger AR, Busis NA, Logigian EL, Wierzbicka M, Shahani BJ. Cervical root stimulation in the diagnosis of radiculopathy. Neurology. 1987;37:329–32.PubMedCrossRefGoogle Scholar
  20. 20.
    Pease WS, Fatehi MT, Johnson EW. Monopolar needle stimulation: safety considerations. Arch Phys Med Rehabil. 1989;70:412–4.PubMedGoogle Scholar
  21. 21.
    Nishida T, Price SJ, Minieta MM. Medial antecubital cutaneous nerve conduction in true thoracic outlet syndrome. Electromyogr Clin Neurophysiol. 1993;33:285–8.PubMedGoogle Scholar
  22. 22.
    Kothari MJ, MacIntosh K, Heistand M, Logigian EL. Medial antebrachial cutaneous sensory studies in the evaluation of neurogenic thoracic outlet syndrome. Muscle Nerve. 1998;21:647–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Seror P. Medial antebrachial cutaneous nerve conduction study, a new tool to demonstrate mild lower brachial plexus lesions. A report of 16 cases. Clin Neurophysiol. 2004;115:2316–22.PubMedCrossRefGoogle Scholar
  24. 24.
    Levin KH, Wilbourn AJ, Maggiano HJ. Cervical rib and median sternotomy related brachial plexopathies. Neurology. 1998;63:1407–13.CrossRefGoogle Scholar
  25. 25.
    Machanic BI, Sanders RJ. Medial antebrachial cutaneous nerve measurements to diagnose neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2008;22:248–54.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of Internal Medicine and Neurology, Rose Medical CenterUniversity of Colorado, School of MedicineDenverUSA

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