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Carpal Tunnel Syndrome

Year 2014, Volume: 67 Issue: 1, 1 - 3, 18.03.2015

Abstract

Carpal tunnel syndrome(CTS) is an entrapment neuropathy of the median nerve at the wrist. CTS’s the most common pathogenesis is thickening flexor retinaculum. The reason of thickening is unclear. Collagen tissue disease, diabetes mellitus, obesite, pregnancy, myxedema, tumors, acute or chronic trauma of forearm, wrist or hand are common things and illness which accompanies with CTS. Nevertheless; in the most patient the cause of CTS is often not apparent and this is called idiopatic carpal tunnel syndrome. Unless associated with direct trauma, the onset of symptoms of CTS is usually nocturnal and insidious. 􀄝nitially, patients suffers paresthesia and dysesthesia in the hand. The diagnosis of CTS based on clinic features. If the diagnosis is uncertain and before surgery, electrophysiologic studies may be useful. In the treatment hand splints, non-steroid antiinflammatory drugs, ultrasound, electrical nerve stimullation may be useful. If the pain and dysesthesia is severe surgery decompresion operation may be done.

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Thanks

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References

  • 1. Chang M.-H., Wei S-J., Chiang H.-L. et all. Comparison of motor conduction techniques in the diagnosis of carpal tunnel syndrome. Neurology 2002; 58: 1603-1607
  • 2. American Academy of Electrodiagnostic Medicine Quality Assurance Committee. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 1993; 16: 1392-1414
  • 3. Stevens JC. The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997; 20: 1477-1486
  • 4. Esther Vögelin, Thomas Meszaros, Franziska Schöni et al. Sonographic wrist measurements and detection of anatomical features in carpal tunnel syndrome. The scientific World journal.2014; 657906: 1-6
  • 5. Robert A. Werner, Michael Andary. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clinical Neurophysiology 2002; 113: 1373–1381
  • 6. Bleecker Margit L, Agnew Jacqueline. New techniques for the diagnosis of carpal tunnel syndrome. Scand J Work Environ Health. 1987; 13: 385-388
  • 7. Stewart JD. Compression and entrapment neuropaties. In: Peripheral Neuropathy, vol.2. 3rd edition. Ed. PJ Dyck and K Thomas. Saunders Company. Philadelphia, London, Toronto, Montreal, Sydney, Tokyo. 1993: 961-979.
  • 8. Lee D, van Holsbeeck MT, Janevski PK et al. Diagnosis of carpal tunnel syndrome: Ultrasound versus electromyography. Radiol Clin North Am. 1999; 37: 859-872
  • 9. Amadio P.C. Historical Review: The Mayo Clin and carpal tunnel syndrome. Mayo Clin Proc 1992; 67: 42-48
  • 10. Pfeffer GB, Gelberman RH, Boyers JH. The History of carpal tunnel syndrome. J Hand Surg Br. 1988: 13; 28-34
  • 11. Bienek T, Kusz D, Cielinski L. Peripheral nerve compression neuropathy after fractures of distal radius. J Hand Surg. 2006: 31; 256-260
  • 12. Marie P, Foix C. Atrophie isolee de l’eminence thenar d’origine nevritique Role du ligament annulaire Role du ligament annulaiere anter ieur de carpe dans la pathogenic de la lesion. Rev Neurol Paris. 1913: 26; 647-649
  • 13. Rengahary S. Entrapment neuropathies, Wilkins R. (Eds.), Neurosurgery, Newyork, Mc. Graw Hill Back Company: 1985: 1771-1777
  • 14. Tindall S.: Chronic injuries of peripheral nerves by entrapment , in Youmans JR (Ed.): Neurological Surgery, Philadelphia, Saunders W.B. : pp. 1990; 2511-2524:
  • 15. Donwart BB. Carpal tunnel syndrome: a review. Semin Arthritis Rheum. 1984: 14;134-140
  • 16. Bagatur AE. Karpal tünel sendromu cerrahisinde ba􀃻ar􀃖s􀃖zl􀃖k nedenleri ve revizyon sonuçlar􀃖. Acta Orthop. Traumatol. Tur. 2002; 36: 346-353
  • 17. Kimura J, Machida M, Kimura A: Median Neuropathies (Ch.4). In: Clinical Electromyography. Edited by WF Brown and CF Bolton, Boston, Butterworths, 1987
  • 18. Harrison MJG: Lack of evidence of generalized sensory neuropathy in patients with carpal tunnel syndrome. J. Neurol Neurosurg Psychiatry 1978; 41: 957-959
  • 19. Robert A. Werner, Michael Andary. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clinical Neurophysiology 2002; 113: 1373–1381
  • 20. Carlos H. Fernandes, Lia M. Meirelles, Jorge Raduan. Carpal tunnel syndrome with thenar atrophy: evaluation of the pinch and grip strength in patients undergoing surgical treatment. Hand. 2013; 8: 60-63
  • 21. Aminoff MJ. Involvement of peripheral vasomotor fibres in Carpal Tunnel Syndrome. J Neurol Neurol Neurosurg Psychiatry 1979; 42: 649-655
  • 22. Ertekin C. Santral ve periferik EMG. İzmir; 2006:416-419 23. Gelmars H. The significance of Tinel’s sign in the diagnosis of carpal tunnel syndrome. Acta Neurochir 1979; 49: 255- 258
  • 24. Nai-Wen Tsai, Lian-Hui Lee, Chi-Ren Huang et al. The diagnostic value of ultrasonography in carpal tunnel syndrome: a comparison between diabetic and non- diabetic patient. BMC neurology. 2013; 13:65
  • 25. Cioni R, Pasero S, Paradiso C, et al. Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. J Neurol 1989; 236: 208-231
  • 26. AAEM, AAN, AAPMR: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve. 1993; 16: 1390- 1391
  • 27. Padua Luca, Monaco Mauro Lo, Valente Enza Maria, et al. A useful electrophysiologic parameter for diagnosis of carpal tunnel syndrome. Muscle Nerve. 1996; 19: 48-53

Karpal Tünel Sendromu

Year 2014, Volume: 67 Issue: 1, 1 - 3, 18.03.2015

Abstract

Karpal tünel sendromu (KTS) median sinirin bilekte tuzak nöropatisidir. KTS’ nin patogenezinde en sık görülen, karpal tünel içi basıncın artmasıdır. Kalınlaşmanın nedeni ise
çok açık değildir. Kollajen doku hastalıkları, diabetes mellitus, şişmanlık, gebelik, miksödem, tümörler, ön kol, bilek veya ele akut yada kronik travma KTS ile birlikte görülen bazı hastalık ve durumlardır. Yine de; hastaların çoğunda altta yatan bir neden bulunmaz ve bu tabloya idiyopatik KTS denir. Direkt travma olmadığı sürece KTS semptomlarının başlangıcı nokturnal ve sinsidir. Başlangıçta hastalar elde parestezilerden ve dizestezilerden rahatsızdırlar. KTS tanısı klinik olarak konur. Tanıdan şüphelenilen durumlarda, cerrahi öncesi elektrofizyolojik yöntemlerden yararlanılabilir. Tedavide gece ateli, non-steroid antienflamatuar ilaçlar, ultrason, elektiriksel sinir uyarısı gibi yöntemler kullanılabilir. Cerrahi dekompresyon ağrı ve uyulmanın dayanılmaz olduğu durumlarda veya motor kayıp varsa düşünülmelidir.

Ethical Statement

-

Supporting Institution

-

Thanks

-

References

  • 1. Chang M.-H., Wei S-J., Chiang H.-L. et all. Comparison of motor conduction techniques in the diagnosis of carpal tunnel syndrome. Neurology 2002; 58: 1603-1607
  • 2. American Academy of Electrodiagnostic Medicine Quality Assurance Committee. Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. Muscle Nerve 1993; 16: 1392-1414
  • 3. Stevens JC. The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997; 20: 1477-1486
  • 4. Esther Vögelin, Thomas Meszaros, Franziska Schöni et al. Sonographic wrist measurements and detection of anatomical features in carpal tunnel syndrome. The scientific World journal.2014; 657906: 1-6
  • 5. Robert A. Werner, Michael Andary. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clinical Neurophysiology 2002; 113: 1373–1381
  • 6. Bleecker Margit L, Agnew Jacqueline. New techniques for the diagnosis of carpal tunnel syndrome. Scand J Work Environ Health. 1987; 13: 385-388
  • 7. Stewart JD. Compression and entrapment neuropaties. In: Peripheral Neuropathy, vol.2. 3rd edition. Ed. PJ Dyck and K Thomas. Saunders Company. Philadelphia, London, Toronto, Montreal, Sydney, Tokyo. 1993: 961-979.
  • 8. Lee D, van Holsbeeck MT, Janevski PK et al. Diagnosis of carpal tunnel syndrome: Ultrasound versus electromyography. Radiol Clin North Am. 1999; 37: 859-872
  • 9. Amadio P.C. Historical Review: The Mayo Clin and carpal tunnel syndrome. Mayo Clin Proc 1992; 67: 42-48
  • 10. Pfeffer GB, Gelberman RH, Boyers JH. The History of carpal tunnel syndrome. J Hand Surg Br. 1988: 13; 28-34
  • 11. Bienek T, Kusz D, Cielinski L. Peripheral nerve compression neuropathy after fractures of distal radius. J Hand Surg. 2006: 31; 256-260
  • 12. Marie P, Foix C. Atrophie isolee de l’eminence thenar d’origine nevritique Role du ligament annulaire Role du ligament annulaiere anter ieur de carpe dans la pathogenic de la lesion. Rev Neurol Paris. 1913: 26; 647-649
  • 13. Rengahary S. Entrapment neuropathies, Wilkins R. (Eds.), Neurosurgery, Newyork, Mc. Graw Hill Back Company: 1985: 1771-1777
  • 14. Tindall S.: Chronic injuries of peripheral nerves by entrapment , in Youmans JR (Ed.): Neurological Surgery, Philadelphia, Saunders W.B. : pp. 1990; 2511-2524:
  • 15. Donwart BB. Carpal tunnel syndrome: a review. Semin Arthritis Rheum. 1984: 14;134-140
  • 16. Bagatur AE. Karpal tünel sendromu cerrahisinde ba􀃻ar􀃖s􀃖zl􀃖k nedenleri ve revizyon sonuçlar􀃖. Acta Orthop. Traumatol. Tur. 2002; 36: 346-353
  • 17. Kimura J, Machida M, Kimura A: Median Neuropathies (Ch.4). In: Clinical Electromyography. Edited by WF Brown and CF Bolton, Boston, Butterworths, 1987
  • 18. Harrison MJG: Lack of evidence of generalized sensory neuropathy in patients with carpal tunnel syndrome. J. Neurol Neurosurg Psychiatry 1978; 41: 957-959
  • 19. Robert A. Werner, Michael Andary. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clinical Neurophysiology 2002; 113: 1373–1381
  • 20. Carlos H. Fernandes, Lia M. Meirelles, Jorge Raduan. Carpal tunnel syndrome with thenar atrophy: evaluation of the pinch and grip strength in patients undergoing surgical treatment. Hand. 2013; 8: 60-63
  • 21. Aminoff MJ. Involvement of peripheral vasomotor fibres in Carpal Tunnel Syndrome. J Neurol Neurol Neurosurg Psychiatry 1979; 42: 649-655
  • 22. Ertekin C. Santral ve periferik EMG. İzmir; 2006:416-419 23. Gelmars H. The significance of Tinel’s sign in the diagnosis of carpal tunnel syndrome. Acta Neurochir 1979; 49: 255- 258
  • 24. Nai-Wen Tsai, Lian-Hui Lee, Chi-Ren Huang et al. The diagnostic value of ultrasonography in carpal tunnel syndrome: a comparison between diabetic and non- diabetic patient. BMC neurology. 2013; 13:65
  • 25. Cioni R, Pasero S, Paradiso C, et al. Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. J Neurol 1989; 236: 208-231
  • 26. AAEM, AAN, AAPMR: Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve. 1993; 16: 1390- 1391
  • 27. Padua Luca, Monaco Mauro Lo, Valente Enza Maria, et al. A useful electrophysiologic parameter for diagnosis of carpal tunnel syndrome. Muscle Nerve. 1996; 19: 48-53
There are 26 citations in total.

Details

Primary Language English
Subjects Neurology and Neuromuscular Diseases
Journal Section Articles
Authors

Buket Tuğan Yıldız

Publication Date March 18, 2015
Published in Issue Year 2014 Volume: 67 Issue: 1

Cite

APA Tuğan Yıldız, B. (2015). Carpal Tunnel Syndrome. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 67(1), 1-3.
AMA Tuğan Yıldız B. Carpal Tunnel Syndrome. Ankara Üniversitesi Tıp Fakültesi Mecmuası. March 2015;67(1):1-3.
Chicago Tuğan Yıldız, Buket. “Carpal Tunnel Syndrome”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 67, no. 1 (March 2015): 1-3.
EndNote Tuğan Yıldız B (March 1, 2015) Carpal Tunnel Syndrome. Ankara Üniversitesi Tıp Fakültesi Mecmuası 67 1 1–3.
IEEE B. Tuğan Yıldız, “Carpal Tunnel Syndrome”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 67, no. 1, pp. 1–3, 2015.
ISNAD Tuğan Yıldız, Buket. “Carpal Tunnel Syndrome”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 67/1 (March2015), 1-3.
JAMA Tuğan Yıldız B. Carpal Tunnel Syndrome. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2015;67:1–3.
MLA Tuğan Yıldız, Buket. “Carpal Tunnel Syndrome”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 67, no. 1, 2015, pp. 1-3.
Vancouver Tuğan Yıldız B. Carpal Tunnel Syndrome. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2015;67(1):1-3.