Electrodiagnostic Studies Role in Diagnosis and Management of Thoracic Outlet Syndrome

Abstract

Introduction: Thoracic outlet syndrome (TOS) is caused by the compressive effect on brachial plexus or

subclavian vessels at the thoracic outlet. The symptoms are usually neurologic, arterial or venous or the

combination of them.

Method: From these patients we chose 70 patients whom underwent surgery (resection of first rib ,with

neurolysis with trans axillary approach) and we had the complete data on EMG -NCV and could follow

postoperative course and were completely satisfied by the operation and their symptoms was relieved

according the quick DASH Questionnaire and thereby the diagnosis of TOS was proved by the result.

Result: The electro diagnostic tests of 6 patients (1.5%) were completely normal. The lower trunk symptoms

which should be more frequent in TOS was purely present in 7.1%. Fibrillation and fasciculation along the

course of ulnar nerve was present in 10% of cases. The middle trunk abnormal motor NCV was the pure

pathology in2.9%. Fibrillation and fasciculation along the course of median nerve (abductor policis berevis)

2.4% and for

Brachioradialis (radial nerve) NCV was abnormal in 1.8%.

Conclusion: To prove this fact, we selected only the patients who were completely satisfied by the operation

and their symptoms was relieved according the quick DASH Questionnaire and thereby we were sure that

the diagnosis of TOS has been correct. Retrospectively we evaluated the electrodiagnostic findings in these

patients.