Electerodiagnostic studies role in Diagnosis and management of thoracic outlet syndrome Download PDF

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. Occasionally, the patient complains of chest pain simulating angina pectoris, or pain at the shoulder, neck or anywhere else in the domain of brachial plexus. There is no pathognomonic test for TOS so far and the diagnosis is dependent to history and physical examination only .Electrodiagnostic studies have been used to show the severity of nerve injuryand see the outcome of surgical intervention and there is not a common finding to make the diagnosis upon that finding. In this study we are trying to prove it. It has been customary to make the diagnosis of TOS if the nerve injury is limited to C8T1 root but we are going to show that this understanding is not correct and we can have injury to any of the cervical plexus roots. Moreover, It is impossible to differentiate the site of injury from roots and trunk by electrodiagnostic studies since we can’t place an electrode over the spinal cord 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.