الفهرس 
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Abstract
Summary
arpal tunnel syndrome (CTS) occurs as the result of compression of the median nerve in the carpal tunnel of the wrist, and is most commonly seen as an entrapment neuropathy, especially in women. It is possible to make a diagnosis with symptoms and findings, but the clinical findings almost always need to be confirmed by electrophysiological examinations.
Conventional nerve conduction studies (NCS) are used for the diagnosis of CTS, but none of the electrophysiological tests on its own has sufficient sensitivity and specificity for the diagnosis of CTS. The most commonly preferred traditional electrophysiological methods in the diagnosis of CTS are median sensory nerve conduction, median motor distal latency, comparison of median and ulnar nerve sensory conduction, and comparison of fourth finger median-ulnar peak latency.
Terminal latency index (TLI) and residual latency (RL), calculated from distal motor latency, distal distance and proximal motor conduction velocities, are electrophysiological parameters used to identify abnormalities in the distal segment of the motor nerve.
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Summary and Conclusion
106 This study was conducted on patients having clinical carpal tunnel syndrome using median nerve residual latency and terminal latency index in order to test their values.
Forty hands of patients with symptoms and signs suggestive of carpal tunnel syndrome as described by Aygül et al. (2009) will was collected from outpatient clinic of Physical medicine, Rheumatology and Rehabilitation department, Ain shams university hospitals. One hundred hands of healthy subjects will was included as a control group the following studies were done in the physical medicine, rheumatlogy and rehabilitation department of ain shams university hospital motor nerve conduction study of the median nerve was obtained by recording from the abductor pollicis bervis motor nerve conduction study of the ulnar nerve was obtained by recording from the abductor digti minimi 3-Sensory conduction study for median and radial nerves for diagnosis of CTS and exclusion of other neuropathic causes.
Our study revealed statistically significant difference in median sensory peak latency and M-R sensory latency difference.
Our results revealed thata thereis a statistically significant difference in median nerve DML and median –ulnar DML difference, residual latency and terminal latency index (P< 0.01) and also revealed no statistical significant difference.
Summary and Conclusion
107 Our results as regards residual latency and median –radial sensory difference revealed a statistical positive correlation .
As regards residual latency and median distal motor latency revealed a positive statistical correlation and as regards residual latency and median –palm to wrist sensory ratio revealed no statistical correlation.
The results as regards terminal latency index and median –radial sensory difference revealed no statistical correlation and also terminal latency index and median distal motor latency revealed a positive statistical correlation and terminal latency index and median palm to wrist sensory ratio revealed no statistical correlation.
The median palm to wrist sensory ratio was the most specific test with a value of 100% then comes the median conduction velocity with value of 91%, then median residual latency with value of 90%, then median terminal latency index with a value of 88% and the least specific was the median motor latency with a value of 86%.
As regard sensitivity, the most sensitive test was median terminal latency index with a value of 75%, then median palm to wrist sensory ratio with a value of 72%, then the median-radial peak latency sensory difference with avalue of 67%, then median residual latency with a value of 57%, then median motor latency with a value of 45 % with the least sensitive test is median conduction velocity with a value of 22%.