| Clinical symptom grading |
| Mild symptoms |
- Tingling or discomfort in median nerve distribution, and
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- No sensory loss or weakness, and
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- CTS symptoms do not disrupt sleep, and
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- No difficulty with hand function or ADLs
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| Moderate symptoms |
- Sensory loss in median distribution, or
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- CTS symptoms (sensory loss or pain) interfere slightly with hand function but patient is able to perform all ADLs, or
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- Nocturnal symptoms may occasionally but not routinely disrupt sleep
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| Severe symptoms |
- Weakness in the median distribution, or
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- CTS symptoms disrupt one or more ADLs; patient is unable to carry out all previous activities, or
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- Nocturnal symptoms routinely disrupt sleep
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| EDX classification[1] |
| Mild CTS |
- Prolonged (relative or absolute) sensory latencies, and
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- Normal motor studies, and
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- No evidence for axon loss
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| Moderate CTS |
- Abnormal median sensory latencies as noted for mild CTS, and
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- Relative or absolute prolongation of median motor distal latency, and
|
| |
| Severe CTS |
- Any of the aforementioned NCS abnormalities with evidence of axon loss as defined by any of the following:
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- An absent or low-amplitude SNAP or mixed NAP
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- A low-amplitude or absent thenar CMAP
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- A needle EMG with fibrillation potentials or motor unit potential changes (large amplitude, long-duration motor unit potentials, or excessive polyphasics)
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