Vibration-induced neuropathy. Detection by nerve conduction measurements.

An analysis of electroneurographic studies of workers who operate hand-held vibrating power tools reveals that, when controlled for polyneuropathy and the effects of heavy manual work, significantly reduced sensory nerve conduction velocities occur within the hands. This finding is compatible with the available pathophysiological evidence. The detection of this presumed vibration-induced neuropathy and its distinction from compression neuropathies involving a localized primary lesion, such as carpal tunnel syndrome, thus requires a detailed investigation of nerve conduction within the hands. A technique well adapted to the detection of abnormalities in the most peripheral sensory nerve fibers and mechanoreceptors has been developed based on vibrotactile stimulation of a fingertip. The compound action potentials recorded noninvasively at the base of the finger and wrist from healthy male subjects possess peak-to-peak amplitudes of no more than 0.5 and 0.25 microV, respectively.