Skip to main content

Thoracic-Outlet Syndrome: Limitations of the Neurophysiological Diagnosis

  • Conference paper
Peripheral Nerve Lesions
  • 236 Accesses

Abstract

The clinical diagnosis of thoracic-outlet syndrome (TOS) is often controversial. While findings are clear in classical or definite cases, they are ambiguous in the majority of patients. Because TOS surgery itself may produce severe brachial plexopathy (Wilbourn 1988), it would be of great advantage if neurophysiological methods in such cases were able to show evidence of involvement of the brachial plexus or of the lower cervical roots distal to their ganglia and thus could differentiate between TOS and other diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Caldwell JW, Crane CR, Krusen EM (1971) Nerve conduction studies: an aid in the diagnosis of the thoracic outlet syndrome. South Med J 64:210–212.

    Article  PubMed  CAS  Google Scholar 

  • Capistrant TD (1977) Thoracic outlet syndrome in whiplash injury. Ann Surg 185:175–178.

    Article  PubMed  CAS  Google Scholar 

  • Cherrington M (1976) Ulnar-conduction velocity in thoracic-outlet syndrome (letter). N Engl J Med 294:1185.

    Google Scholar 

  • Chodoroff G, Lee DW, Honet JC (1985) Dynamic approach in the diagnosis of thoracic outlet syndrome using somatosensory evoked responses. Arch Phys Med Rehabil 66:3–6.

    PubMed  CAS  Google Scholar 

  • Dale WA, Lewis MR (1975) Management of thoracic outlet syndrome. Ann Surg 181:575–585.

    Article  PubMed  CAS  Google Scholar 

  • Daube JR (1975) Nerve conduction studies in thoracic outlet syndrome (abstract). Neurology 25:347.

    Google Scholar 

  • Dawson DM, Hallett M, Millender LH (1983) Entrapment neuropathies. Little, Brown & Co, Boston Toronto, pp 169–183.

    Google Scholar 

  • Dorfman LJ (1979) F-wave latency in the cervical-rib-and-band syndrome (letter). Muscle & Nerve 2:158–159.

    Article  CAS  Google Scholar 

  • Eisen A, Schomer D, Melmed C (1977) The application of F-wave measurements in the differentiation of proximal and distal upper limb entrapments. Neurology 27:662–668.

    PubMed  CAS  Google Scholar 

  • Gilliatt RW (1976) Thoracic outlet compression syndrome (letter). Br Med J 1:1274–1275.

    Article  Google Scholar 

  • Gilliatt RW, LeQuesne PM, Logue V, Sumner AJ (1970) Wasting of the hand associated with a cervical rib or band. J Neurol Neurosurg Psychiat 33:615–624.

    Article  PubMed  CAS  Google Scholar 

  • Gilliatt RW, Willison RG, Dietz V, Williams IR (1978) Peripheral nerve conduction in patients with a cervical rib and band. Ann Neurol 4:124–129.

    Article  PubMed  CAS  Google Scholar 

  • Glassenberg M (1981) The thoracic outlet syndrome: an asessment of 20 cases with regard to new clinical and electromyographic findings. Angiology 32:180–186.

    Article  PubMed  CAS  Google Scholar 

  • Glover JL, Worth RM, Bendick PJ, Hall PV, Markland OM, (1981) Evoked responses in the diagnosis of thoracic outlet syndrome. Surgery 89:86–93.

    PubMed  CAS  Google Scholar 

  • Huffman JD (1986) Electrodiagnostic techniques for and conservative treatment of thoracic outlet syndrome. Clin Orthopaed Rel Res 207:21–23.

    Google Scholar 

  • Jebsen RH (1967) Motor conduction velocity in the median and ulnar nerves. Arch Phys Med Rehabil 48:185–194.

    PubMed  CAS  Google Scholar 

  • Jerrett SA, Cuzzone LJ, Pasternak BM (1984) Thoracic outlet syndrome. Electrophysiological reappraisal. Arch Neurol 41:960–963.

    Article  PubMed  CAS  Google Scholar 

  • Kimura J (1983) Electrodiagnosis in diseases of nerve and muscle: principles and practice. Davis, Philadelphia, pp 454–455.

    Google Scholar 

  • Krogness K (1973) Ulnar trunk conduction studies in the diagnosis of the thoracic outlet syndrome. Acta Clin Scand 139:597–603.

    CAS  Google Scholar 

  • Krusen EM, Urschel HC (1976) Ulnar conduction velocity in thoracic-outlet syndrome. Reply (letter). N Engl J Med 294:1185–1186.

    Google Scholar 

  • Lascelles RG, Mohr PD, Neary D, Bloor K (1977) The thoracic outlet syndrome. Brain 100:601–612.

    Article  PubMed  CAS  Google Scholar 

  • London GW (1975) Normal ulnar nerve conduction velocity across the thoracic outlet: comparison of two measuring techniques. J Neurol Neurosurg Psychiat 38:756–760.

    Article  PubMed  CAS  Google Scholar 

  • Morales-Blanquez G, Delwaide PJ (1982) The thoracic outlet syndrome: an electrophysiological study. Electromyogr Clin Neurophysiol 22:255–263.

    PubMed  CAS  Google Scholar 

  • Newmark J, Levy SR, Hochberg FH (1985) Somatosensory evoked potentials in thoracic outlet syndrome (letter). Arch Neurol 42:1036.

    Article  PubMed  CAS  Google Scholar 

  • Ryding E, Ribbe E, RosĂ©n I, Norgren L (1985) A neurophysiologic investigation of thoracic outlet syndrome. Acta Chir Scand 151:327–331.

    PubMed  CAS  Google Scholar 

  • Sadler TR Jr, Rainer WG, Twombley G (1975) Thoracic outlet compression. Application of positional arteriography and nerve conduction studies. Am J Surg 130:704–706.

    Article  PubMed  CAS  Google Scholar 

  • Shahani BT, Potts F, Juguilon A, Young RR (1980) Electrophysiological studies in “thoracic outlet syndrome” (abstract). Muscle & Nerve 3:182–183.

    Google Scholar 

  • Smith T, Trojaborg W (1987) Diagnosis of thoracic outlet syndrome. Arch Neurol 44:1161–1163.

    Article  PubMed  CAS  Google Scholar 

  • Swinton NW Jr, Wanger SL (1972) Thoracic-outlet syndrome (letter). N Engl J Med 287:567.

    Article  Google Scholar 

  • Upton ARM, McComas AJ (1973) The double crush in nerve-entrapment syndromes. Lancet 2:359–362.

    Article  PubMed  CAS  Google Scholar 

  • Urschel HC Jr, Razzuk MA (1972) Management of the thoracic outlet syndrome (current concepts). N Engl J Med 286:1140–1143.

    Article  PubMed  Google Scholar 

  • Urschel HC Jr, Razzuk MA, Wood RE, Parekh M. Paulson DL (1971) Objective diagnosis (ulnar nerve conduction velocity) and current therapy of the thoracic outlet syndrome. Ann Thorac Surg 12:608–620.

    Article  PubMed  Google Scholar 

  • Weber RJ, Piero DL (1978) F wave evaluation of thoracic outlet syndrome: a multiple regression derived F wave latency predicting technique. Arch Phys Med Rehabil 59:464–469.

    PubMed  CAS  Google Scholar 

  • Wilbourn AJ (1988) Thoracic outlet syndrome surgery causing severe brachial plexopathy. Muscle & Nerve 11:66–74.

    Article  CAS  Google Scholar 

  • Wulff CH, Gilliatt RW (1979) F waves in patients with hand wasting caused by a cervical rib and band. Muscle & Nerve 2:452–457.

    Article  CAS  Google Scholar 

  • Yiannikas C, Walsh JC (1983) Somatosensory evoked responses in the diagnosis of thoracic outlet syndrome. J Neurol Neurosurg Psychiat 46:234–240.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Krämer, G., Kleider, A. (1990). Thoracic-Outlet Syndrome: Limitations of the Neurophysiological Diagnosis. In: Samii, M. (eds) Peripheral Nerve Lesions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75611-5_51

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-75611-5_51

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-75613-9

  • Online ISBN: 978-3-642-75611-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics