Elsevier

The Journal of Hand Surgery

Volume 11, Issue 5, September 1986, Pages 693-699
The Journal of Hand Surgery

Digital vibrogram: A new diagnostic tool for sensory testing in compression neuropathy+,++

https://doi.org/10.1016/S0363-5023(86)80014-4Get rights and content

A Békésy audiometer was modified for use in analysis of vibrotactile sensibility of the hand at frequencies ranging from 8 to 500 Hz. In control subjects the “digital vibrogram” has a typical shape, which differs characteristically in patients with carpal tunnel syndrome (CTS). Changes in digital vibrogram usually parallel or precede abnormalities in neurophysiologic tests, and appear long before changes in two-point discrimination (2PD). One-hundred-thirty-two hands of 76 patients diagnosed as having CTS were tested with a vibrometer. Of 113 hands with normal 2PD, the digital vibrogram showed abnormal in 86 cases. Of 19 hands with abnormal 2PD, the digital vibrogram showed abnormal in all but three cases. Twenty-six hands with neurophysiologically normal appearance had abnormal digital vibrogram in 14 cases, while 53 hands neurophysiologically classified as CTS showed abnormal digital vibrogram in 44 cases. It is concluded that the digital vibrogram is a useful tool for early diagnosis of CTS.

References (36)

  • E Moberg

    Critisism and study of methods for examining sensibility in the hand

    Neurology

    (1962)
  • E Moberg

    Methods for examining sensibility of the hand

  • AL Dellon

    Clinical use of vibratory stimuli to evaluate peripheral nerve injury and compression neuropathy

    Plast Reconstr Surg

    (1980)
  • RH Gelberman et al.

    Carpal tunnel syndrome

    Results of a prospective trial of steroid injection and splinting. J Bone Joint Surg [Am]

    (1980)
  • RM Szabo et al.

    Sensibility testing in patients with carpal tunnel syndrome

    J Bone Joint Surg [Am]

    (1984)
  • RH Gelberman et al.

    Sensibility testing in peripheral nerve compression syndromes

    An experimental study in humans. J Bone Joint Surg [Am]

    (1983)
  • GS Phalen

    Spontaneous compression of the median nerve at the wrist

    JAMA

    (1951)
  • GS Phalen

    The carpal tunnel syndrome

    Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg [Am]

    (1966)
  • Cited by (102)

    • Sensibility Testing

      2016, Hand and Upper Extremity Rehabilitation: A Practical Guide
    • Progress in vibrotactile threshold evaluation techniques: A review

      2011, Journal of Hand Therapy
      Citation Excerpt :

      This results in the selective excitation of PCs at frequencies above 100 Hz. Merkel discs are active below 6.3 Hz, and Meissner’s corpuscles are activated between16 and 32 Hz.6,10,14,18 These unique properties of individual MRs have been used to develop vibrometry techniques to identify information about the innervating nerve.52–54

    • Median Nerve Compression

      2006, Hand and Upper Extremity Rehabilitation
    • Sensibility Testing

      2006, Hand and Upper Extremity Rehabilitation
    • Evaluation of nerve injury and nerve compression in the upper quadrant

      2005, Journal of Hand Therapy
      Citation Excerpt :

      Innervation density represents the number of innervated sensory receptors and can be assessed with two-point discrimination (2pd). Threshold testing of the sensory receptors will permit the earliest quantification of changes occurring with chronic nerve compression.32,44,49,52,53,61–65 Alterations in the innervation density will not occur until the later stages of chronic nerve compression and measures of two-point discrimination will remain normal until the patient has more severe nerve compression.11,32,66,67

    View all citing articles on Scopus
    +

    Supported by grants from the Swedish Medical Research Council, No. 5188, the Swedish Work Environmental Fund, and the University of Lund.

    ++

    Presented at the Fortieth Annual Meeting of the American Society for Surgery of the Hand, Las Vegas, Nevada, January, 1985.

    View full text