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NEUROLOGY 1987;37:1499
© 1987 American Academy of Neurology

Lurnbrical sparing in carpal tunnel syndrome

Anatomic, physiologic, and diagnostic implications

E. L. Logigian, MD, N. A. Busis, MD, A. R. Berger, MD, F. Bruyninckx, MD, N. Khalil, MD, B. T. Shahani, MD, DPh and R. R. Young, MD

Clinical Neurophysiology Laboratory, Massachusetts General Hospital, Boston, MA.

Motor axons supplying lumbrical muscles are less severely affected than axons supplying thenar muscles in the carpal tunnel syndrome; sometimes lumbrical motor fibers are less affected than digit 2 sensory fibers. This pattern is consistent with compression of both the anterior and posterior aspects of the median nerve in the carpal tunnel because nerve fibers responsible for thenar, lumbrical, and digit 2 functions lie in an anterior-posterior gradient within the distal median nerve. Recognition of lumbrical sparing supports the electrodiagnosis of carpal tunnel syndrome when the distal latency to thenar muscles or the palm-to-wrist mixed median nerve conduction velocity is normal.

Address correspondence and reprint requests to Dr. Logigian, Department of Neurology, New England Medical Center, 750 Washington Street, Boston, MA 02111.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.

Received October 17, 1985. Accepted for publication in final form December 16, 1986.




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[Abstract] [PDF]


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