scholarly journals Association of Carpal Tunnel Syndrome in Diabetes Patient

Author(s):  
K. Jaganath ◽  
Arun Kumar ◽  
Sathish Kumar ◽  
K. Nithish Raj ◽  
P. Sanmuga Sundaram

Objective: The objective of our study was to determine Prevalence of carpel tunnel syndrome among diabetic patients and the significant association between carpel tunnel syndrome and diabetes mellitus. Materials and Methods: Study was conducted on 250 patients at Saveetha medical college and hospital. Study was conducted after getting proper ISE approval. Subjects were selected according to inclusion and exclusive criteria's. For every study subject after getting consent demographic information, past medical history of Diabetes such as type, duration, any associated complication (diabetic neuropathy, retinopathy, etc.), medication, and lifestyle modification were obtained via a self-reporting structured questionnaire and confirmed by the subject's medical record. For every subject, clinical tests such as Tinel's test and Phalen test were performed and nerve conduction study was used for diagnose carpal tunnel syndrome among the subjects who were showing positive clinical test. All data collected were entered into the standardized database and statistic analysis was calculated. Results: After analysing the data collected on association between carpel tunnel syndrome and a diabetes patient. Conclusion: It implies that there is a significant relationship between carpal tunnel syndrome and diabetes patients.

1998 ◽  
Vol 23 (1) ◽  
pp. 114-114 ◽  
Author(s):  
D. G. PARTHENIS ◽  
C. B. KARAGKEVREKIS ◽  
M. A. WALDRAM

We describe a patient who developed acute carpal tunnel syndrome due to spontaneous bleeding without a history of injury. Immediate decompression relieved the symptoms. Further haematological investigations revealed that the patient was suffering from von Willebrand’s disease.


Diabetology ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 226-231
Author(s):  
Carlos Antonio Guillen-Astete ◽  
Monica Luque-Alarcon ◽  
Nuria Garcia-Montes

Background: Carpal tunnel syndrome is the most prevalent peripheral nerve entrapment condition of the upper limb. Among metabolic risk factors, diabetes is considered the most relevant. Although wrist ultrasound assessment of the median nerve has demonstrated a good correlation with the gold standard for the diagnosis of this syndrome, neurophysiological study, its usefulness in patients with diabetes is questionable because the compressive phenomenon is not the predominant one. Method: We conducted a retrospective study to compare the clinical and median nerve ultrasound features of patients with carpal tunnel syndrome previously diagnosed or not diagnosed with diabetes. Additionally, a linear multivariate regression analysis was performed to determine to what extent the cross-sectional area of the median nerve was dependent on the condition of diabetes by fixing other variables such as sex, age, or time of evolution. Results: We included 303 records of patients (mean age 44.3 ± 11.7 years old, 57.89% female, mean of time of evolution 13.6 ± 8.3 months) from 2012 to 2020. The cross-sectional area of the median nerve was 10.46 ± 1.44 mm2 in non-diabetic patients and 8.92 ± 0.9 mm2 in diabetic patients (p < 0.001). Additionally, diabetic patients had a shorter time of evolution (7.91 ± 8.28 months vs. 14.36 ± 0.526 months, p < 0.001). In the multivariate analysis, the resultant model (fixed R-square = 0.659, p = 0.003) included a constant of the following four variables: the evolution time (Beta coeff. = 0.108, p < 0.001 95% CI 0.091 to 0.126, standardized coeff. = 0.611), the condition of diabetes (Beta coeff. = −0.623, p < 0.001 95% CI −0.907 to −0.339, standardized coeff. = −0.152), the severity (Beta coeff. = 0.359, p = 0.001 95% CI 0.147 to 0.571, standardized coeff. = 0.169), and the masculine sex (Beta coeff. = 0.309, p = 0.003, 95% CI 0.109 to 0.509, standardized coeff. = 0.103). Conclusions: Ultrasound assessment of the median nerve in patients with diabetes is not a useful tool to confirm whether carpal tunnel syndrome should be diagnosed or not diagnosed.


Author(s):  
Ahmadreza Afshar ◽  
Ali Tabrizi

AbstractCarpal tunnel syndrome (CTS), a common neuropathy of the upper limb, is highly prevalent in diabetic patients. Recent findings indicate that changes in median nerve elasticity and its gliding characteristics may contribute to the development of CTS. Normally, each nerve should be able to adapt to the positional changes by passive movement relative to the surrounding tissues. This ability is provided by a gliding apparatus around the nerve trunk in the surrounding soft tissue. The fascicles of nerve trunks can also glide against each other (interfascicular gliding). Sonoelastography indicates that nerve elasticity is decreased in patients with CTS compared to healthy patients. Moreover, decreased nerve elasticity in diabetes mellitus type II is associated with increased neuropathy, especially in peripheral nerves. Biomechanical factors, oxidative stress, and microvascular defects are also observed in diabetic neuropathy and account for different complications. A reduction in the elasticity of peripheral nerves may be related to decreased interfascicular gliding because of the biomechanical changes that occur in neuropathy. Surgical treatments, including nerve release and reduction of carpal tunnel pressure, improve peripheral gliding but do not resolve disease symptoms completely. According to the evidence, interfascicular gliding dysfunction is the most important factor in the pathogenesis of CTS in diabetic patients. Available evidence suggests that biomechanical variations affect interfascicular gliding more than peripheral gliding in diabetic patients. Decreased nerve elasticity is strongly correlated with decreased interfascicular gliding. It is further hypothesized that the concurrent use of antioxidants and pharmacological treatment (neuroprotection) such as alpha lipoic acid with carpal tunnel release in diabetic patients may alleviate the interfascicular gliding dysfunction and improve median neve elasticity. Decreased nerve elasticity and interfascicular gliding dysfunction play significant roles in the pathogenesis of CTS in diabetic patients.


1989 ◽  
Vol 82 (6) ◽  
pp. 349-350 ◽  
Author(s):  
J S Wand

In a retrospective postal study of 27 women who have developed carpal tunnel syndrome (CTS) in the puerperium, the condition was found to affect predominantly elderly primiparous women (mean age 31.5 years). The condition was associated with breastfeeding in 24 women. The three who did not breastfeed had less severe symptoms which resolved within one month of onset. The symptoms developed a mean of 3.5 weeks following delivery, lasted 6.5 months and started to resolve within 14 days of weaning. Symptomatic treatments with either splint-age, diuretics, non-steroidal anti-inflammatory drugs or steroid injections provided some benefit. Two patients required surgical decompression. All patients were symptom-free by one year.


1998 ◽  
Vol 23 (2) ◽  
pp. 151-155 ◽  
Author(s):  
F. GERR ◽  
R. LETZ

The performance of a variety of common office-based clinical tests for detection of carpal tunnel syndrome (CTS) was assessed in 119 subjects with and without electrophysiological evidence of CTS. Symptoms compatible with CTS and electrophysiological tests positive for median mononeuropathy at the wrist were observed in 57 hands, symptoms compatible with CTS and normal electrophysiological test results were observed in 58 hands, and no symptoms compatible with CTS and normal electrophysiological test results were observed in 123 hands. For all the diagnostic tests studied, the proportion of subjects who had a false positive clinical test result was much higher in the electrophysiologically normal subjects who had CTS compatible hand symptoms than in the electrophysiologically normal subjects who were asymptomatic. These results suggest that many studies that have evaluated diagnostic tests for CTS have produced falsely optimistic estimates of the test’s performance because of their use of asymptomatic comparison subjects.


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