Electrodiagnostic features of true neurogenic thoracic outlet syndrome

Introduction: We report the electrodiagnostic (EDX) features of 32 patients with surgically verified true neurogenic thoracic outlet syndrome (TN-TOS). Methods: Retrospective record review. Results: We found uniform EDX evidence of a chronic axon loss process that affected the lower portion of the brachial plexus and disproportionately involved the T1 more than the C8 sensory and motor fibers. Because of this relationship, the medial antebrachial cutaneous sensory nerve (T1) and median motor (T1>C8) study combination was abnormal in 89%, whereas response combinations that primarily assessed the C8 fibers were less frequently affected. Conclusions: The characteristic EDX features of TN-TOS are T1>C8 nerve fiber involvement. A comprehensive EDX examination of the lower plexus with contralateral comparison studies is imperative to diagnose this disorder accurately.© 2013 Wiley Periodicals, Inc.