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Abstract : Carpal tunnel syndrome (CTS) is a constellation of clinical signs and symptoms that arise from median nerve compression and slowing at the wrist joint through the carpal tunnel. This research examines the effects of Tinel's, Phalen's, and Durkan's provocative tests, which are often used to diagnose CTS, on median nerve electrodiagnostic measures. The neurophysiology section of Al-Imamain Al-Kadhimain Medical City hospital in Baghdad, Iraq, conducted a prospective cohort research from February to August 2022 on 57 female CTS patients. All patients had their median nerve sensory and motor components assessed at baseline and after each of the three provocative tests, with two minutes between each. Median nerve latency parameters (DML, SL, minimal F latency) were significantly prolonged, while Compound motor action potential (CMAP) amplitude, Motor nerve conduction velocity (MNCV), Sensory nerve action potential (SNAP) amplitude, and SNCV values all decreased significantly after each of these three provocative tests (P<0.05). Electrodiagnostic parameters of the three clinical provocative tests indicated non-significant differences (P>0.05). Phalen's sensory measures (SL and SNCV), MNCV, and CMAP amplitude had the greatest sensitivity and specificity percentages among the three provocative tests, whereas the other parameters had inconsistent findings. Phalen's test exhibited the best sensitivity and specificity of the tested assays, highlighting its clinical provocative value in CTS identification.

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