scholarly journals 516 Prevalence of carpal tunnel syndrome in patients with transthyretin cardiac amyloidosis

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giancarlo Trimarchi ◽  
Alessia Perna ◽  
Mattia Zampieri ◽  
Alessia Argirò ◽  
Robert Runinski ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Cardiac Amyloidosis ◽  
Common Finding ◽  
Wild Type ◽  
Neurological Phenotype ◽  
Red Flag ◽  
Tunnel Syndrome ◽  
Mixed Phenotype ◽  
Bilateral Carpal Tunnel Syndrome

Abstract Aims Carpal tunnel syndrome (CTS) represents an important red flag for transthyretin (ATTR) cardiac amyloidosis (CA). However, no large studies have investigated the prevalence of CTS in wild type ATTR (wtATTR) and hereditary ATTR (hATTR). To investigate the prevalence of CTS in patients with ATTR-CA, both wild type and hereditary, differentiating between monolateral and bilateral carpal tunnel syndrome. Methods and results 381 patients, 308 male and 73 female, with a definite diagnosis of ATTR CA have been evaluated. Among these, 230 patients with diagnosis of wild-type ATTR (wtATTR) and 151 patients with hereditary ATTR (hATTR) were identified. Patients with diagnosis of hATTR are sorted according to phenotype in cardiologic (43 patients) and mixed when both cardiologic and neurologic phenotype are observed (108 patients). Patients with neurological phenotype without CA were excluded. Overall, CTS is present in 57.6% of ATTR patients; A higher prevalence (P < 0.05) of CTS was observed in wtATTR (61.6%) respect to hATTR (51.7%). Monolateral isolated CTS is significantly frequent (P < 0.05) in patients with hATTR (35.1%) than in wtATTR (12.7%), on the contrary bilateral CTS is significantly more frequent (P < 0.05) in patients with wtATTR (48.5%) than in hATTR (16.6%). Among patients with hATTR, of the 43 patients with cardiologic phenotype, 18 patients (41.9%) have diagnosis of CTS, subdivided in 28% with monolateral CTS and 72% with bilateral CTS. Among hATTR patients with mixed phenotype, 55.6% have diagnosis of CTS, subdivided in 80% with monolateral isolated CTS and 20% with bilateral CTS. Among 151 patients with hATTR, monolateral isolated CTS is significantly more present in patients with mixed phenotype (80% vs. 27%, P < 0.001) while bilateral CTS is significantly more frequent in patients with cardiologic phenotype (72.2% vs. 20%, P < 0.001). Conclusions CTS particularly with bilateral involvement is a common finding in wtATTR patients than in hATTR patients. On the contrary, monolateral isolated CTS is significantly more frequent in patients with hATTR than in wtATTR. Among patients with hATTR, bilateral CTS is significantly more frequent in patients with cardiologic phenotype than mixed phenotype while monolateral isolated CTS is significantly more present in patients with mixed phenotype.

Severe bilateral carpal tunnel syndrome in juvenile chronic arthritis

2003 ◽  
Vol 29 (4) ◽  
pp. 345-348 ◽  
Author(s):  
Oya Ünal ◽  
Levent Özçakar ◽  
Alp Çetin ◽  
Bayram Kaymak
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Juvenile Chronic Arthritis ◽  
Chronic Arthritis ◽  
Tunnel Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

The Relationship of the Double Crush to Carpal Tunnel Syndrome (An Analysis of 1,000 Cases of Carpal Tunnel Syndrome)

1985 ◽  
Vol 10 (2) ◽  
pp. 202-204
Author(s):  
LAWRENCE C. HURST ◽  
DAVID WEISSBERG ◽  
ROBERT E. CARROLL
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Surgery ◽  
Significant Incidence ◽  
Tunnel Syndrome ◽  
Relationship Of ◽  
The Relationship ◽  
Double Crush ◽  
Double Crush Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

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.

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 Amyloidotic muscle pseudohypertrophy: case report

2001 ◽  
Vol 59 (3A) ◽  
pp. 582-586 ◽  
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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