Surgeon Ratings of the Severity of Idiopathic Median Neuropathy at the Carpal Tunnel Are Not Influenced by Magnitude of Incapability

ABSTRACTWe present a case of carpal tunnel syndrome (CTS) due to compression of the median nerve within the carpal tunnel, caused by cysticercosis. Nerve conduction studies revealed severe CTS. Magnetic resonance imaging suggested an inflammatory mass compressing the median nerve in carpal tunnel. The histological diagnosis was consistent with cysticercosis. The case resolved with conservative treatment. Such solitary presentation of entrapment median neuropathy as CTS caused by cysticercosis is extremely rare. To our knowledge, this is the only case of its kind reported in literature till date.

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Comparison of Borderline Ultrasound and Nerve Conduction Studies for Carpal Tunnel Syndrome

Hand ◽

10.1177/1558944720964963 ◽

2020 ◽

pp. 155894472096496

Author(s):

Cory Demino ◽

John R. Fowler

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Nerve Conduction Studies ◽

Threshold Values ◽

Cutoff Values ◽

Number Of Patients ◽

Tunnel Syndrome ◽

Median Neuropathy

Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

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Foreign Body in the Median Nerve: a Complication of Acupuncture

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_90_90063-a ◽

1990 ◽

Vol 15 (1) ◽

pp. 111-112

Author(s):

S. R. SOUTHWORTH ◽

R. H. HARTWIG

Keyword(s):

Peripheral Neuropathy ◽

Foreign Body ◽

Median Nerve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Potential Complication ◽

Acupuncture Needle ◽

Median Neuropathy

Fracture of an acupuncture needle resulted in a foreign body within the carpal tunnel of a patient who then developed median neuropathy. The needle fragment was recovered from within the median nerve during carpal tunnel release, with rapid post-operative relief of symptoms. Development of peripheral neuropathy is a potential complication of acupuncture.

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PERSONAL FACTORS AND BLOOD VOLUME MOVEMENT IN CAUSATION OF MEDIAN NEUROPATHY AT THE CARPAL TUNNEL

American Journal of Physical Medicine & Rehabilitation ◽

10.1097/00002060-199605000-00019 ◽

1996 ◽

Vol 75 (3) ◽

pp. 235-238 ◽

Cited By ~ 20

Author(s):

Patrick Radecki

Keyword(s):

Blood Volume ◽

Carpal Tunnel ◽

Personal Factors ◽

Median Neuropathy

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Median Neuropathy—Carpal Tunnel Syndrome

10.1093/med/9780190617127.003.0001 ◽

2018 ◽

Author(s):

Meghan E. Lark ◽

Nasa Fujihara ◽

Kevin C. Chung

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Clinical Case ◽

Carpal Tunnel Release ◽

Treatment Strategies ◽

Comprehensive Management ◽

Tunnel Syndrome ◽

Release Management ◽

Phalen's Test ◽

Median Neuropathy

This chapter presents general treatment strategies for carpal tunnel syndrome using a clinical case example. It discusses assessment and planning, diagnostic pearls, decision-making, surgical procedures (open and endoscopic carpal tunnel release), management pearls, aftercare, complications and their management, and evidence and outcomes. Physical exams, such as Phalen’s test or a Tinel sign over the median nerve, are introduced, whereas steps in the surgical procedure are shown with intraoperative photographs. The chapter provides information on modern practices for comprehensive management of carpal tunnel syndrome from start to finish.

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