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.

Value of Electrodiagnostic Tests in Carpal Tunnel Syndrome

2000 ◽  
Vol 25 (4) ◽  
pp. 361-365 ◽  
Author(s):  
A. F. DUDLEY PORRAS ◽  
P. ROJO ALAMINOS ◽  
J. I. VIÒUALES ◽  
M. A. RUIZ VILLAMAÒAN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Sensory Nerve ◽  
Sensory Nerve Conduction Velocity ◽  
Tunnel Syndrome ◽  
A Prospective Study

Eighty-five patients who were treated surgically for carpal tunnel syndrome were reviewed by a prospective study to assess the relationship between electrodiagnostic tests and clinical outcome. Before surgery all patients completed a self-administered questionnaire, and an electrophysiological examination was done to assess distal motor latency, sensory and motor amplitudes, and sensory nerve conduction velocity. After 6 months follow-up all these tests were repeated. There was significant correlation between improvement in sensory nerve conduction velocity and clinical improvement at follow-up.

scholarly journals Diagnosis and Management of Carpal Tunnel Syndrome in Children with Mucopolysaccharidosis: A 10 Year Experience

Diagnostics ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 5 ◽  
Author(s):  
Ivana Dabaj ◽  
Cyril Gitiaux ◽  
Daniela Avila-Smirnow ◽  
Jacques Ropers ◽  
Isabelle Desguerre ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Motor Nerve ◽  
Sensory Nerve ◽  
Disease Diagnosis ◽  
Tunnel Syndrome

Introduction: Mucopolysaccharidoses (MPS) are rare and clinically heterogeneous lysosomal storage disorders. Carpal tunnel syndrome (CTS) is a frequent complication in MPS types I, II, VI, and VII. CTS symptoms are difficult to recognize in these children, and often there is a lack of appropriate investigations. Patients and methods: In this retrospective study, all MPS patients were referred to the electrodiagnostic (EDX) laboratory of a single academic center during a 10-year period. Forty-eight children underwent serial EDX studies for CTS diagnosis and follow-up after surgery. Forty-two patients were diagnosed with CTS. Sensory nerve conduction velocity (SNCV), distal motor latency (DML), and motor nerve conduction velocity through the wrist (MNCV-W) of the median nerve were reviewed and analyzed. Results: One-hundred-three EDX examinations were performed on 48 patients. The median age at disease diagnosis was 2.1 years versus 4.9 years for CTS diagnosis. Analysis of the series revealed that electrophysiological abnormalities of CTS could have started much earlier (before the age of 2 years or at diagnosis of MPS). Diagnosis was based on SNCV and DML results, and MNCV-W was taken into consideration. Bilateral CTS was frequent (88%) in the types of MPS studied in our population and was observed from the first year of life, and may not have be associated with obvious clinical symptoms. EDX studies also helped in the follow-up and detection of CTS relapses, thus leading to an early intervention allowing a better recovery. Conclusion: EDX studies should be performed promptly and regularly in these patients. Prospective studies are required in order to understand the effect of disease-specific therapies in preventing the development of CTS in these patients. Synopsis: EDX studies should be performed in MPS patients soon after diagnosis and during routine follow-up, before and after surgical decompression.

scholarly journals Age and Body Anthropometry as Predicting Factors for Carpal Tunnel Syndrome among Egyptian Obese Women

2020 ◽  
Vol 8 (B) ◽  
pp. 930-934
Author(s):  
Moushira Zaki ◽  
Maha Ali ◽  
Walaa Yousef ◽  
Wafaa Ezzat ◽  
Walaa Basha
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Obese Women ◽  
Tunnel Syndrome ◽  
Obesity Indices ◽  
Predictor Factors

BACKGROUND: Carpal tunnel syndrome (CTS) is the most prevalent entrapment neuropathy in the upper limb. The most consistent risk factors are female gender, age, and obesity. The results of previous studies are conflicting, and moreover, data from studies regarding obesity and nerve conduction velocity are not available for our Egyptian population. AIM: This study was designed to investigate the contribution of age and body anthropometry as predictor factors to the CTS and to identify patients at high risk for CTS among Egyptian obese women. METHODS: The study included 120 obese women grouped according to the clinical and electrodiagnostic (EDX) findings into two groups: 60 with CTS and 60 without CTS (non-CTS). EDX study was used in the diagnosis of median nerve entrapment at the level of the wrist, according to the American Association of Neuromuscular and EDX Medicine. Body weight and height were measured and then body mass index (BMI) was calculated. Waist-to-hip ratio (WHR) was determined from the measured waist circumference (WC) and hip circumference (HC). Mid upper arm circumference (MUAC) was measured as well. The receiver operating characteristic (ROC) curve was used to assess the power of age and body anthropometry as predictor factors for CTS. RESULTS: CTS obese cases showed significantly lower values of both median motor nerve conduction velocity (MMNCV) and median sensory nerve conduction velocity compared to those without CTS. Significantly higher median sensory latency and median motor latency have been found in CTS cases compared to non-CTS group. Significant differences in the mean age have been found between the two groups and a tendency for higher body anthropometry measures in the CTS cases relative to those without CTS. Moreover, there were negative correlations between MMNCV and obesity indices. Age showed the highest area under the ROC curve, followed by BMI, WHR WC, HC, and MUAC. CONCLUSION: Age and obesity indices are important risk factors that can be used as predictors to CTS in obese women. Age is a more powerful diagnostic tool relative to the anthropometric measurements. Women of age above 40 years and suffering from a high degree of obesity are at risk of developing CTS.

scholarly journals The effects of vitamin D supplementation in carpal tunnel syndrome treatment outcomes: a systematic review

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Chirathit Anusitviwat ◽  
Porames Suwanno ◽  
Sitthiphong Suwannaphisit
Keyword(s):  
Vitamin D ◽  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Treatment Outcomes ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Vitamin D Supplementation ◽  
Tunnel Syndrome

Abstract Purpose Vitamin D deficiency is related to carpal tunnel syndrome symptoms. Correcting vitamin D levels by supplementation was supposed to improve carpel tunnel symptoms, though there is a lack of aggregated data about treatment outcomes. This study aimed to examine whether vitamin D supplementation could improve the treatment outcomes in carpal tunnel syndrome patients. Methods A comprehensive search of the PubMed, Cochrane Library, Scopus, and Web of Science databases for articles on vitamin D and carpel tunnel syndrome from January 2000 to March 2021 was performed. The article screening and data extraction were performed by two investigators independently with blinding to decisions on selected studies. All included studies had assessed the quality of evidence using the Methodological Index for Non-Randomized Studies (MINORS) scoring system. Results We retrieved four studies that met the eligibility criteria. The treatment outcomes were evaluated by visual analog scale (124 wrists), functional scores (176 patients), muscle strength (84 patients), and nerve conduction velocity (216 wrists). After vitamin D supplementation, two studies reported improved pain scores and nerve conduction velocity, and three studies showed enhancement of functional status. Conclusion Vitamin D administration could offer favorable outcomes in pain improvement, better functional status, and increased sensory conduction velocity in carpal tunnel syndrome. However, there is to date no recommendations concerning a standardized dose or duration of vitamin D administration in carpal tunnel syndrome; prescribing vitamin D at the usual appropriate dose is suggested as an additional treatment in patients with mild to moderate carpel tunnel symptoms. Level of Evidence Level IV, therapeutic study

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