Atypical carpal tunnel syndrome with compression of the ulnar and median nerves

1981 ◽  
Vol 54 (5) ◽  
pp. 668-669 ◽  
Author(s):  
Vagn Eskesen ◽  
Jarl Rosenørn ◽  
Ole Osgaard
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Clinical Signs ◽  
Content Type ◽  
Nerve Involvement ◽  
Tunnel Syndrome ◽  
Fine Print

✓ Clinical signs of ulnar nerve involvement at the wrist level were found in a 51-year-old man. The electrophysiological changes were indicative of a median nerve involvement in the carpal tunnel. At operation, the compressed ulnar nerve was found in the carpal tunnel, together with the median nerve. This localization of the ulnar nerve has not been described previously.

Surgery of the carpal tunnel

1978 ◽  
Vol 49 (2) ◽  
pp. 316-318 ◽  
Author(s):  
Noel Eboh ◽  
Donald H. Wilson
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Modified Technique ◽  
Content Type ◽  
Electrical Studies ◽  
Entrapment Neuropathies ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Fine Print

✓ The authors describe a modified technique for surgery of the carpal tunnel. The primary cause of the carpal tunnel syndrome is the same as other entrapment neuropathies: an enlarged nerve within a tight tunnel. Electrical studies have shown that the area of compression is in the middle of the tunnel. Treatment is surgical: a palmar incision, which begins at the wrist medial to the palmaris longus, to avoid damage to the sensory branch of the median nerve; and section of the retinaculum from the exit of the tunnel toward the entrance.

Magnetic resonance neurography studies of the median nerve before and after carpal tunnel decompression

2002 ◽  
Vol 96 (6) ◽  
pp. 1046-1051 ◽  
Author(s):  
Simon A. Cudlip ◽  
Franklyn A. Howe ◽  
Andrew Clifton ◽  
Martin S. Schwartz ◽  
B. Anthony Bell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Decompression ◽  
Mr Neurography ◽  
Magnetic Resonance Neurography ◽  
Content Type ◽  
Before And After ◽  
Tunnel Syndrome ◽  
Fine Print

Object. Recently developed novel MR protocols called MR neurography, which feature conspicuity for nerve, have been shown to demonstrate signal change and altered median nerve configuration in patients with median nerve compression. The postoperative course following median nerve decompression can be problematic, with persistent symptoms and abnormal results on electrophysiological studies for some months, despite successful surgical decompression. The authors undertook a prospective study in patients with carpal tunnel syndrome, correlating the clinical, electrophysiological, and MR neurography findings before and 3 months after surgery. Methods. Thirty patients and eight control volunteers were recruited to the study. The MR neurography consisted of axial and sagittal images (TR = 2000 msec, TE = 60 msec) obtained using a temporomandibular surface coil, fat saturation, and flow suppression. Maximum intensity projection images were used to follow the median nerve through the carpal tunnel in the sagittal plane. Magnetic resonance neurography in patients with carpal tunnel syndrome demonstrated proximal swelling (p < 0.001) and high signal change in the nerve, together with increased flattening ratios (p < 0.001) and loss of nerve signal in the distal carpal tunnel (p < 0.05). Sagittal images were very effective in precisely demonstrating the site and severity of nerve compression. After surgery, division of the flexor retinaculum could be demonstrated in all cases. Changes in nerve configuration, including increased cross-sectional area, and reduced flattening ratios (p < 0.001) were seen in all patients. In many cases restoration of the T2 signal intensity toward that of controls was seen in the median nerve in the distal carpal tunnel. Sagittal images were excellent in demonstrating expansion of the nerve at the site of surgical decompression. Conclusions. In this study the authors suggest that MR neurography is an effective means of both confirming compression of the median nerve and its successful surgical decompression in patients with carpal tunnel syndrome. This modality may prove useful in the assessment of unconfirmed or complex cases of carpal tunnel syndrome both before and after surgery.

Carpal tunnel syndrome in pediatric mucopolysaccharidoses

1975 ◽  
Vol 43 (1) ◽  
pp. 102-103 ◽  
Author(s):  
Michael E. Miner ◽  
R. Neil Schimke
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Pediatric Patients ◽  
Surgical Decompression ◽  
Content Type ◽  
Careful Clinical Examination ◽  
Tunnel Syndrome ◽  
Fine Print

✓ Four pediatric patients with mucopolysaccharidoses and an associated carpal tunnel syndrome are presented. Findings in these cases were typical of the adult form of median nerve compression at the wrist, but the patients had minimal symptoms in view of these findings. The importance of careful clinical examination and early surgical decompression is emphasized.

Anomalous course of the recurrent motor branch of the median nerve in a patient with carpal tunnel syndrome

1977 ◽  
Vol 47 (1) ◽  
pp. 113-114 ◽  
Author(s):  
J. Douglas Werschkul
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Motor Branch ◽  
Content Type ◽  
Tunnel Syndrome ◽  
Fine Print

✓ A case is discussed in which carpal tunnel syndrome with an unusual course of the motor recurrent branch was discovered at operation. The importance of a careful dissection of the median nerve in this condition is emphasized.

scholarly journals Carpal Tunnel Syndrome Associated with Klippel-Trénaunay Syndrome: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 161-164
Author(s):  
Joan Arenas-Prat ◽  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Peripheral Nerves ◽  
Distribution Area ◽  
Left Hand ◽  
Nerve Involvement ◽  
Tunnel Syndrome ◽  
Operative Findings ◽  
Klippel Trenaunay Syndrome

Background and Importance: Klippel-Trénaunay syndrome is a rare congenital condition that rarely affects peripheral nerves. Median nerve involvement at the carpal tunnel level has only been reported on four occasions of this syndrome in the medical literature. Case Presentation: A 61-year-old Caucasian female patient with Klippel-Trénaunay syndrome presented with a 10-month history of paraesthesia and numbness affecting the median nerve distribution area of her left hand. The clinical and neurophysiological examination confirmed a moderately severe carpal tunnel syndrome that required surgical decompression. Conclusion: Pre-operative findings demonstrated diffuse vascular infiltration and engorgement of the median nerve. Flexor tendons had a normal appearance. The patient had a satisfactory post-operative period with full resolution of her symptoms 4 weeks after the procedure. Although peripheral nerves are rarely affected in patients with Klippel-Trénaunay syndrome, neurological symptoms could indicate nerve involvement and magnetic resonance imaging (MRI) examination should be considered to further assess the extension of the lesion.

Ulnar and Median Nerve Abnormalities in Carpal Tunnel Syndrome

2020 ◽  
Vol 22 (5) ◽  
pp. 313-322
Author(s):  
Filip Georgiew ◽  
Andrzej Maciejczak ◽  
Jakub Florek ◽  
Ireneusz Kotela
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Control Group ◽  
Conduction Disturbances ◽  
Tunnel Syndrome ◽  
Sensory Fibers ◽  
American Academy Of Neurology

Background. Nerve compression underlying carpal tunnel syndrome (CTS) results in an increase in the threshold of superficial sensation in the area supplied by the median nerve, which is a mixed nerve dominated by sensory fibres. The distribution of sensory symptoms is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment at wrist level is still unclear. Patho­logical processes leading to median neuropathy in CTS may affect ulnar nerve motor and sensory fibers in the Guyon canal. This may explain the extra-median spread of sensory symptoms in CTS patients. Material and methods. The study involved 88 patients (104 hands), with 70 women (83 hands) and 18 men (21 hands) aged between 25 and 77 years. 50 age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. The diagnosis of carpal tunnel syndrome was made according to the criteria of the American Academy of Neurology 1993 guidelines. Based on the results of an ENG trace evaluating the degree of conduction disturbances in the median nerve, the patients were classified to one of three severity subgroups. The threshold of sensory excitability to pulsed current was determined in a test with single 100 ms rectangular pulses. Conclusions. 1. The threshold of sensation in the fingers innervated by the median and ulnar nerve is significantly lon­ger in patients with CTS than in controls. 2. Surgical treatment decreases the threshold of sensation in the fingers innervated by the median nerve. 3. Surgical treatment does not decrease the threshold of sensation in the fingers innervated by the ul­nar nerve. 4. The preoperative and postoperative threshold of sensation in the fingers innervated by the median and ulnar nerve is significantly longer in patients with severe carpal tunnel than in mild and moderate cases.

Carpal tunnel syndrome caused by thrombosis of the median artery: importance of high-resolution ultrasonography for diagnosis

2002 ◽  
Vol 97 (2) ◽  
pp. 471-473 ◽  
Author(s):  
Henrich Kele ◽  
Raphaela Verheggen ◽  
Carl Detlev Reimers
Keyword(s):  
High Resolution ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Content Type ◽  
The Third ◽  
Tunnel Syndrome ◽  
Median Artery ◽  
High Resolution Ultrasonography ◽  
Fine Print

✓ The rare case of a patient with carpal tunnel syndrome caused by thrombosis of a persistent median artery is presented. Progressive pain in the wrist and dysesthesias in the third and fourth fingers were the atypical complaints. High-resolution ultrasonography revealed a bifid median nerve that was compressed by an occluded median artery. The intraoperative findings are described, and emphasis is placed on the importance of using high-resolution ultrasonography for presurgical diagnosis.

Effect of exercise on nerve conduction study of Carpal tunnel syndrome patients

2021 ◽  
pp. 4157-4160
Author(s):  
J. K Sahoo ◽  
A. G Joshi ◽  
K. N Sahoo
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Research Work ◽  
Clinical Signs ◽  
Common Disease ◽  
Exercise Treatment ◽  
Significant Difference ◽  
Tunnel Syndrome

Background: Carpal tunnel syndrome is the most common entrapment neuropathy of the median nerve at the wrist. In general population CTS is known to be a very common disease and the prevalence of CTS is estimated to be 2.7% as confirmed by clinical and electrophysiological findings. Typical symptoms of CTS are tingling, numbness and parasthesia in thumb, index, middle finger and radial half of ring finger which is often exaggerated at night. Previously research studies have been done on pain control, grip strength, wrist function. Very little research work has been done on effect of exercise on NCS of CTS patients. So the aim of the study is to find the short term (6weeks) effects of exercise on NCS of CTS patients. Methodology: Bilateral sensory and motor nerve conduction studies were carried out in 50 CTS patients before and after 6weeks of exercise. Exercise treatment was given to patients under the guidance of trained physiotherapist. Clinical examination was also done after 6 weeks. RMS machine from Chandigarh was used. Statistical analysis was done by INSTAT- 3.6 software. Result: DML, DML (diff.) DSL, DSL (diff.) showed significant decrease after 6 weeks of exercise in symptomatic (Rt.) hand, but no significant difference was found in SCV, CMAP, SNAP of median nerve. Whereas in Lt. hand only DML (diff.) between median and ulnar nerve showed significant change. There was also improvement in clinical signs and symptoms and pain scale. Conclusion: It was concluded that exercise treatment for 6 weeks under the proper guidance of trained physiotherapist showed significant improvements in clinical as well as electrophysiological parameters in symptomatic hands. So, exercise treatment can be suggested as choice of treatment for CTS patients.

scholarly journals The Association Between Concomitant Ulnar Nerve Compression at the Elbow and Carpal Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Brandon Shulman ◽  
Jonathan Bekisz ◽  
Christopher Lopez ◽  
Samantha Maliha ◽  
Siddharth Mahure ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Concomitant Treatment ◽  
Ulnar Nerve Compression ◽  
Median Nerve Compression ◽  
Number Of Patients ◽  
Tunnel Syndrome

Background: Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment. Results: In the SPARCS database, the percentage of patients surgically treated for concomitant UNE and CTS steadily increased from 23% in 2003 to 45% in 2014. At our institution, 50 of 222 patients (23%) surgically treated for UNE underwent concomitant carpal tunnel releases. For concomitantly treated patients, 94% had examinations consistent with UNE and CTS, 87% of patients had median nerve compression on electrodiagnostic tests, and 72% of patients had UNE on electrodiagnostic tests. Conclusions: Most patients concomitantly treated for UNE and CTS have objective findings of both conditions. At least one-fourth of patients indicated for operative ulnar nerve release also require a carpal tunnel release—far beyond the prevalence of CTS in the general population. A diagnosis of UNE merits a comprehensive workup by the treating surgeon and a high suspicion for concomitant median nerve compression.

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