Severe bilateral carpal tunnel syndrome in juvenile chronic arthritis

In this series of 1,000 cases of carpal tunnel syndrome (888 patients) there is a statistically significant incidence of bilaterality in patients with cervical arthritis. There is also a statistically significant increase in the incidence of diabetes mellitus over the general population. These findings lend further support to Upton’s Double Crush hypothesis. Further, the double crush syndrome predisposes to bilateral carpal tunnel syndrome and may be an important prognostic factor. It may also be an explanation for some of the failures following carpal tunnel surgery and lead surgeons to look for other associated systemic diseases or mechanical blocks, when attempting to alleviate recalcitrant symptoms.

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

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12628812460092 ◽

2010 ◽

Vol 92 (5) ◽

pp. 403-405 ◽

Cited By ~ 5

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.

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Amyloidotic muscle pseudohypertrophy: case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2001000400018 ◽

2001 ◽

Vol 59 (3A) ◽

pp. 582-586 ◽

Cited By ~ 4

Author(s):

Rosana Herminia Scola ◽

Lineu Cesar Werneck ◽

Cássio Slompo Ramos ◽

Ricardo Pasquini ◽

Hans Graf ◽

...

Keyword(s):

Bone Marrow ◽

Case Report ◽

Bone Marrow Transplantation ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Muscle Hypertrophy ◽

Type I ◽

Subjective Improvement ◽

Tunnel Syndrome ◽

Bilateral Carpal Tunnel Syndrome

The authors report one case of amyloidosis associated with muscular pseudohypertrophy in a 46-year-old woman, who developed weakness, macroglossia and muscle hypertrophy associated with primary systemic amyloidosis. Electromyography showed a myopathic pattern and bilateral carpal tunnel syndrome. The muscle biopsy presented with a type I and II fiber hypertrophy and infiltration of amyloid material in the interstitious space and artery walls. She underwent bone marrow transplantation with stabilization and subjective improvement of the clinical picture.

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