Unilateral Carpal Tunnel Syndrome and Space-Occupying Lesions

1993 ◽  
Vol 18 (6) ◽  
pp. 748-749 ◽  
Author(s):  
K. NAKAMICHI ◽  
S. TACHIBANA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Physical Examination ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Signs And Symptoms ◽  
Careful Examination ◽  
Plain Radiographs ◽  
Tunnel Syndrome ◽  
Bilateral Carpal Tunnel Syndrome ◽  
Space Occupying Lesion

To assess the association between unilateral carpal tunnel syndrome and space-occupying lesions, 128 patients have been reviewed. They were divided into bilateral, subclinical (unilateral signs and symptoms, and bilateral slowing in the median nerve conduction) and unilateral carpal tunnel syndrome. Space-occupying lesions were investigated on the basis of physical examination and wrist imaging using plain radiographs and ultrasonograms. Of 20 patients with unilateral carpal tunnel syndrome, space-occupying lesions were found in seven (occult ganglion in five and occult calcified mass in two). In contrast, none of 89 patients with bilateral carpal tunnel syndrome and 19 with subclinical carpal tunnel syndrome had space-occupying lesions. We conclude that careful examination and wrist imaging on suspicion of local pathology, especially a space-occupying lesion, are needed when the condition is unilateral and the aetiology is not clear from the history and on physical examination.

scholarly journals High incidence of absent nerve conduction in older patients with bilateral carpal tunnel syndrome

2010 ◽  
Vol 92 (5) ◽  
pp. 403-405 ◽  
Author(s):  
BO Povlsen
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Older Patients ◽  
Age Group ◽  
Sensory Conduction ◽  
Satisfactory Outcome ◽  
High Incidence ◽  
Tunnel Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

INTRODUCTION Carpal tunnel syndrome has been reported by some to have a less satisfactory outcome in older patients following surgery. However, this impression is not supported by other investigators but no objective explanation has been suggested for these differences. In our department, such patients are routinely treated with night wrist splints and, if this is unsatisfactory, they are investigated with nerve conduction studies prior to surgery. PATIENTS AND METHODS This paper reports the neurophysiological outcome in a young (< 40 years of age) and an older (> 60 years of age) group of patients with clinical bilateral carpal tunnel syndrome who did not benefit from splints. RESULTS The results showed that both the motor and sensory conduction speeds are significantly lower in the older age group. More importantly in the older group, half had one or more hands where the sensory conduction was absent. In four out of these 10 patients this finding was bilateral and three patients had unilateral absent motor conduction. In the younger group, no patient had absent conduction. CONCLUSIONS Poor surgical outcome in some older patients may be because of irreversibly damaged nerves prior to surgery and pre-operative neurophysiology is, therefore, recommended both for clinical and medicolegal reasons.

scholarly journals Screening for Carpal Tunnel Syndrome in Patients With Mucopolysaccharidosis

2020 ◽  
Vol 35 (6) ◽  
pp. 410-417 ◽  
Author(s):  
Prajay Patel ◽  
Georgia Antoniou ◽  
Damian Clark ◽  
David Ketteridge ◽  
Nicole Williams
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Physical Examination ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Lysosomal Storage Diseases ◽  
Nerve Conduction Studies ◽  
Screening Methods ◽  
Lysosomal Storage ◽  
Mucopolysaccharidosis I ◽  
Tunnel Syndrome

Mucopolysaccharidoses (MPSs) are a group of rare lysosomal storage diseases with multisystem manifestations, including carpal tunnel syndrome (CTS). This study comprised a systematic review of literature and hospital guidelines addressing the method and frequency of screening for carpal tunnel syndrome in mucopolysaccharidosis patients and a review of carpal tunnel syndrome in patients seen in the multidisciplinary mucopolysaccharidosis clinic of a pediatric hospital, in order to develop screening recommendations. The literature reported the importance of routine carpal tunnel syndrome screening from early childhood in patients with mucopolysaccharidosis I, II, IV, and VI. Screening methods included physical examination, nerve conduction studies, electromyography, and ultrasonography. Ten of 20 mucopolysaccharidosis patients in our series underwent carpal tunnel syndrome surgery. Given the high incidence of carpal tunnel syndrome at a young age in mucopolysaccharidosis, the authors recommend performing physical examination and obtaining patient and caregiver history for carpal tunnel syndrome every 6 months from the time of mucopolysaccharidosis diagnosis, supplemented by annual nerve conduction studies in cases with poor history or equivocal examination.

scholarly journals Electroneuromyography and neuromuscular findings in 16 primary hypothyroidism patients

1996 ◽  
Vol 54 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Márcia W. Cruz ◽  
Mauro Tendrich ◽  
Mário Vaisman ◽  
Sérgio A. P. Novis
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Signs And Symptoms ◽  
Primary Hypothyroidism ◽  
Muscle Enzyme ◽  
Clear Cut ◽  
Neurological Signs ◽  
Tunnel Syndrome

There has been few reports on electroneuromyography (ENMG) changes in hypothyroidism. The objectives of the present study were to investigate the frequency of ENMG abnormalities in hypothyroidism and correlate them with neurological signs and symptoms and muscle enzyme levels; and to compare latency, amplitude and nerve conduction velocity from selected nerves with controls. Sixteen patients suffering from primary hypothyroidism were submitted to ENMG before treatment. ENMG abnormalities were found in 87.5% of the patients; 46.6% had myopathy and 43.7% had carpal tunnel syndrome. There was no case of polyneuropathy. A clear-cut clinical, laboratorial and ENMG correlation was observed in patients with myopathy and carpal tunnel syndrome. The patients showed a significant tendency of nerve conduction slowness as compared with controls. The findings are in accordance with the well-known nerve and muscle damage in hypothyroidism.

Carpal Tunnel Syndrome: Impairment Rating by the AMA Guides, Fifth Edition

2006 ◽  
Vol 11 (1) ◽  
pp. 1-3, 9-10 ◽  
Author(s):  
James B. Talmage ◽  
Christopher R. Brigham ◽  
Charles N. Brooks
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Physical Examination ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Motor Impairments ◽  
Needle Electromyography ◽  
Axon Loss ◽  
Uniform Definition ◽  
Tunnel Syndrome ◽  
Definition Of

Abstract The pain, numbness, and paresthesias of carpal tunnel syndrome generally are intermittent and are felt in the wrist, hand, thumb, and fingers, often in a distribution approximating that of the median nerve. No specific physical examination exists for carpal tunnel syndrome, and, in the impairment rating assessment, the physical examination focuses on detecting signs of permanent nerve damage (decreased sensation and thenar weakness on opposition). According to the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), provocative tests have no role in impairment rating. The AMA Guides, Fifth Edition, requires nerve conduction testing (NCT), even in “believable” instances, but no uniform definition of an abnormal NCT exists and examiners should realize the uses and limits of NCT. For example, if the NCT is normal, the symptoms, even if believable, do not rise to the level of an impairment. Impairment assessment must take place when the patient is at maximum medical improvement. If the NCT is grossly abnormal (axon loss) and/or degenerative changes are present on needle electromyography, and if physical exam shows sensory and/or thenar weakness, the examiner can use tables in the AMA Guides to rate the disability, combining sensory and motor impairments as appropriate. A one-page sidebar in this issue of The Guides Newsletter addresses the causes of carpal tunnel syndrome.

Electrophysiological and Clinical Improvement in Non-Invasive Treatment of Carpal Tunnel Syndrome

2020 ◽  
Vol 20 ◽  
Author(s):  
Riccardo Marvulli ◽  
Giancarlo Ianieri ◽  
Grazia Devenuto ◽  
Marta Falcicchio ◽  
Giulia A. Gallo ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Sleep Quality ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Pantothenic Acid ◽  
Sensory Nerve ◽  
Sensory Nerve Conduction Velocity ◽  
Tunnel Syndrome

Background and Objective: Carpal tunnel syndrome (CTS) is the most common form of nerve entrapment. Clinically, various signs and symptoms compare due to overexposure to mechanical vibrations transmitted to the wrist bones and cartilage, resulting in compression of the sensory and motor nerve fibers of median nerve. Early symptoms include nocturnal paresthesia and electromyography reveals reduced sensory nerve conduction velocity. Aim of this study was to evaluate the efficacy of a dietary integrator composed of acetyl-L-carnitine, α-lipoic acid,quercetin, bromelain, pantothenic acid, C and B1 and B2 and B6 and B12 vitamins in patients with early (minimal) carpal tunnel syndrome. Methods: 36 patients (28 female and 8 male) with early CTS characterized by sensory nerve demyelination and inflammation of the transverse carpal ligament. Patients were divided into two groups, group A (18 patients received physical therapy) and group B (18 patients, received physical therapy and an oral integrator). Clinical (sleep quality questionnaire to measure severity of paresthesia) and neurophysiological assessment (Sensory Nerve Conduction Velocity) performed at baseline, and then at 30 and 60 days after treatment. Results: Sleep quality and Sensory Nerve Conduction Velocity data analysis show improvement in both groups at 30 and 60 days, with statistically difference between them in both time of analysis. Conclusions: In the early CTS, with sensory fibers damage, use of dietary integrator, such as Micronil Dol®, composed composed of acetyl-L-carnitine, α-lipoic acid,quercetin, bromelain, pantothenic acid, C and B1 and B2 and B6 and B12 vitamins can be effective in quick recovery of median nerve sensory.

scholarly journals Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods

2021 ◽  
Vol 18 (4) ◽  
pp. 1995
Author(s):  
Valentina Scalise ◽  
Fabrizio Brindisino ◽  
Leonardo Pellicciari ◽  
Silvia Minnucci ◽  
Francesca Bonetti
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Manual Therapy ◽  
Carpal Tunnel ◽  
Signs And Symptoms ◽  
Current Evidence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Therapeutic Exercises ◽  
Chi Squared ◽  
Tunnel Syndrome

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

Hand-held nerve conduction device in carpal tunnel syndrome: A prospective study

2012 ◽  
Vol 45 (5) ◽  
pp. 635-641
Author(s):  
S. Veronica Tan ◽  
Fiona Sandford ◽  
Mark Stevenson ◽  
Sara Probert ◽  
Sue Sanders ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Prospective Study ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Tunnel Syndrome ◽  
A Prospective Study
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