The paraplegic hand: electrodiagnostic studies and clinical findings.

Motor conduction times of median and ulnar nerves at the wrist were determined in 60 paraplegic male patients. In 30 of the patients (50%), 56 of the 240 nerves studied (23%) were abnormal. The incidence of abnormal conduction times was not reliably correlated with either age or duration of paralysis. The fact that patients a few years after injury had conduction times as severe as patients with long-standing paraplegia, regardless of age, indicates that an early disease process may take place in the patient's hands, although previous authors have reported different findings. Of patients with abnormal conduction times 44% were asymptomatic. Median nerve decompression was performed on these patients when they became symptomatic. Periodic examinations are recommended for all paraplegic patients so that early diagnosis can be made and differentiated from symptoms more proximal in the extremity. Although nerve conduction studies are not recommended for all asymptomatic patients, we now request them more liberally in younger patients with early symptoms to confirm the diagnosis.