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Electrodiagnostic Findings and Clinical Symptoms of the Contralateral Side in Patients With Abnormal Distal Sensory Latency of the Median Nerve
Charlotte E.S. Hoogstins, BA; Stéphanie J.E. Becker, MD; David C. Ring, MD, PhD;
Massachusetts General Hospital

Purpose: To test the hypothesis that electrodiagnostic evidence of CTS in the contralateral, less severe side correlates with disease severity.

Methods: We retrospectively reviewed 233 adult patients that had bilateral electrodiagnostic testing and a median nerve distal sensory latency (DSL) greater than 3.6 ms one at least one side. Variables significantly associated with abnormal median nerve DSL on the contralateral side were analyzed in bivariate analysis and backwards stepwise logistic regression analysis.

Results: The contralateral side had electrodiagnostic abnormalities in 73% (89.2% of patients with a non-recordable DSL) and clinical symptoms in 76% of patients. Among patients with a recordable DSL there was a strong correlation with the DSL of the opposite side. A multivariable logistic regression model for electrodiagnostic abnormalities on the less severe side included only non-recordable DSL.

Discussion: The finding that disease severity is the strongest predictor of contralateral abnormalities is consistent with the concept that CTS is—in general--a structural/genetic disease that slowly advances and eventually appears on the other side.

Level of evidence: Prognostic II

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