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Documentation of posttraumatic nerve compression in patients with normal electrodiagnostic studies.

Dr. Alan Shih
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Coert JH, Meek MF, Gibeault D, Dellon AL.

BACKGROUND: Electrodiagnostic evaluation may suggest the absence of posttraumatic nerve compression in the presence of patient symptoms. Computer-assisted neurosensory testing documents peripheral nerve sensory impairment. In the setting of trauma, where there are often legal implications, documentation of peripheral nerve compression is important. This is highlighted in the diabetic, who may have neuropathy. METHODS: A prospective study tracked trauma-related peripheral nerve problems in patients with "normal" electrodiagnostic studies, and for whom surgical care or legal outcome was determined by documentation of abnormalities by testing with the Pressure-Specified Sensory Device. Eight patients were identified, four of whom had diabetes. RESULTS: In all eight patients, neurosensory testing documented peripheral nerve problems, which was critical in obtaining approval from workers' compensation insurance carrier for decompression of the nerve and facilitating legal settlement. CONCLUSION: Neurosensory testing with the Pressure-Specified Sensory Device identifies peripheral nerve compression related to trauma, facilitating management of the patient, even in the presence of diabetic neuropathy.

J Trauma. 2004 Feb;56(2):339-44.