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Carpal Tunnel Syndrome and Migraine Lateralization

Year 2024, Volume: 34 Issue: 4, 536 - 541, 31.08.2024
https://doi.org/10.54005/geneltip.1468141

Abstract

Background/Aims: Within the scope of this research, we aimed to elucidate the relationship between carpal tunnel syndrome and migraine to explore both the pain intensity and the localization of carpal tunnel syndrome (CTS) in concomitant migraine. The primary outcome variable was elaborated as the pain lateralization, and the secondary outcome variable was the pain intensity.
Methods: This was a cross-sectional, observational prospective study of 500 patients with a preliminary carpal tunnel syndrome diagnosis in our institution. After patients with missing data were excluded from the study, 413 remained, 365 (88.4%) women and 48 (11.6%) men. After recording the demographic characteristics, the patient's migraine pain year of onset of pain, pain characteristics, localization, frequency, duration, severity, triggering factors, symptoms, and findings accompanying the pain were recorded.
Results: The lateralization of migraine was on the right side (only on the right or mostly on the right) in 25.9% and on the left side (only on the left or mostly on the left) in 26.4% of the patients. Almost half of the patients (47.7%) experienced bilateral migraine headaches. Carpal tunnel syndrome was in the right hand in 13.3%, in the left hand in 11.6%, and bilateral in 75.1%. Of 197 patients with bilateral pain, 68 (34.5%) had mild, 116 (58.9%) had moderate, and 13 (6.6%) had severe CTS. The VAS level of migraine pain was higher only in patients with CTS in the left hand and in those with moderate CTS.
Conclusion: It has been determined that those with carpal tunnel syndrome on the right side have migraines mostly on the right, those with carpal tunnel syndrome on the left have migraines on the left, and those with carpal tunnel syndrome in both directions have migraines predominantly in both directions.

References

  • Padua L, Cuccagna C, Giovannini S, Coraci D, Pelosi L, Loreti C, et al. Carpal tunnel syndrome: updated evidence and new questions. Lancet Neurol. 2023 Mar;22(3):255-267.
  • Sevy JO, Sina RE, Varacallo M. Carpal Tunnel Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 29, 2023.
  • Rotem G, Arami A. Carpal Tunnel Syndrome. Isr Med Assoc J. 2023;25(7):507-510.
  • Li ZM, Jordan DB. Carpal tunnel mechanics and its relevance to carpal tunnel syndrome. Hum Mov Sci. 2023;87:103044.
  • Puledda F, Silva EM, Suwanlaong K, Goadsby PJ. Migraine: from pathophysiology to treatment. J Neurol. 2023;270(7):3654-3666.
  • Steiner TJ, Stovner LJ. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol. 2023;19(2):109-117.
  • Koyuncu, G. "Coexistence of Migraine and Carpal Tunnel Syndrome " Journal of Samsun Health Sciences 7(2), 2022: 407-418.
  • Wiberg A, Lucey MA, Kleeman S, Kang Y, Ng M, Furniss D. Genetic correlations between migraine and carpal tunnel syndrome. Plast Reconstr Surg. Published online August 18, 2023.
  • Gfrerer L, Chartier C, Lans J, Eberlin KR, Austen WG Jr. A Correlation between Upper Extremity Compressive Neuropathy and Nerve Compression Headache. Plast Reconstr Surg. 2021;148(6):1308-1315.
  • Gfrerer L, Lans J, Chartier C, Wenzinger E, Austen WG Jr, Eberlin KR. Migraine Headaches in Patients with Upper Extremity Compressive Neuropathy. Plast Reconstr Surg. 2022;150(6):1333-1339.
  • Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005 Jan;115(1):1-9.
  • Kung TA, Guyuron B, Cederna PS. Migraine surgery: a plastic surgery solution for refractory migraine headache. Plast Reconstr Surg. 2011;127:181–189.
  • Dodick DW, Turkel CC, DeGryse RE, Aurora SK, Silberstein SD, Lipton RB, et al.; PREEMPT Chronic Migraine Study Group. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010 Jun;50(6):921-36.
  • Janis JE, Hatef DA, Reece EM, McCluskey PD, Schaub TA, Guyuron B. Neurovascular compression of the greater occipital nerve: implications for migraine headaches. Plast Reconstr Surg. 2010 Dec;126(6):1996-2001.
  • Turkel CC, Aurora S, Diener HC, Dodick DW, Lipton RB, Silberstein SD, et al. Treatment of chronic migraine with Botox (onabotulinumtoxinA): Development, insights, and impact. Medicine (Baltimore). 2023 Jul 1;102(S1):e32600.
  • Baraldi C, Lo Castro F, Ornello R, Sacco S, Pani L, Guerzoni S. OnabotulinumtoxinA: Still the Present for Chronic Migraine. Toxins (Basel). 2023;15(1):59. Published 2023 Jan 10.
  • Law HZ, Amirlak B, Cheng J, Sammer DM. An Association between Carpal Tunnel Syndrome and Migraine Headaches-National Health Interview Survey, 2010. Plast Reconstr Surg Glob Open. 2015;3(3):e333. Published 2015 Apr 7.
  • La Pegna GB, Quatrosi G, Vetri L, Reina F, Galati C, Manzo ML, et al. Migraine and handedness. Neurol Sci. 2021;42(7):2965-2968. DOI:10.1007/s10072-021-05111-7
  • Tang QY, Lai WH, Tay SC. The Effect of Hand Dominance on Patient-Reported Outcomes of Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome. J Hand Surg Asian Pac Vol. 2017;22(3):303-308.
  • Blum ASS, Riggins NY, Hersey DP, Atwood GS, Littenberg B. Left- vs right-sided migraine: a scoping review. J Neurol. 2023;270(6):2938-2949.

Karpal Tünel Sendromu ve Migren Lateralizasyonu

Year 2024, Volume: 34 Issue: 4, 536 - 541, 31.08.2024
https://doi.org/10.54005/geneltip.1468141

Abstract

Amaç: Bu araştırma kapsamında, eşlik eden migrende karpal tünel sendromunun (KTS) hem ağrı yoğunluğunu hem de lokalizasyonunu araştırmak için karpal tünel sendromu ile migren arasındaki ilişkiyi aydınlatmayı amaçladık. Birincil sonuç değişkeni, ağrının lateralizasyonu olarak detaylandırıldı ve ikincil sonuç değişkeni, ağrının yoğunluğuydu.
Yöntemler: Bu araştırma, kurumumuzda karpal tünel sendromu ön tanısı alan 500 hastanın katıldığı kesitsel, gözlemsel, prospektif bir çalışma olarak planlanmıştır. Verileri eksik olan hastalar çalışma dışı bırakıldıktan sonra 365’i (%88,4) kadın, 48’i (%11,6) erkek olmak üzere 413 kişi kaldı. Hastanın demografik özellikleri kaydedildikten sonra migren ağrısının başlangıç yılı, ağrının özellikleri, lokalizasyonu, sıklığı, süresi, şiddeti, tetikleyici faktörler, ağrıya eşlik eden semptomlar ve bulgular kaydedildi.
Bulgular: Migrenin lateralizasyonu hastaların %25,9’unda sağ tarafta (sadece sağda veya çoğunlukla sağda), %26,4’ünde ise sol tarafta (sadece solda veya çoğunlukla solda) idi. Hastaların neredeyse yarısında (%47,7) iki taraflı migren baş ağrısı görüldü. Karpal tünel sendromunun %13,3’ü sağ elde, %11,6’sı sol elde, %75,1’i ise iki taraflıydı. Bilateral ağrısı olan 197 hastanın 68’inde (%34,5) hafif, 116’sında (%58,9) orta ve 13’ünde (%6,6) şiddetli KTS vardı. Migren ağrısının VAS düzeyi sadece sol elde KTS’si olanlarda ve orta derecede KTS’si olanlarda daha yüksekti.
Sonuç: Sağ tarafta karpal tünel sendromu olanların migren hastalarının çoğunlukla sağda, solda karpal tünel sendromu olan hastaların migren ağrılarının solda, her iki yönde de karpal tünel sendromu olanların her iki yönde migren ağırlıklı olduğu belirlendi.

References

  • Padua L, Cuccagna C, Giovannini S, Coraci D, Pelosi L, Loreti C, et al. Carpal tunnel syndrome: updated evidence and new questions. Lancet Neurol. 2023 Mar;22(3):255-267.
  • Sevy JO, Sina RE, Varacallo M. Carpal Tunnel Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 29, 2023.
  • Rotem G, Arami A. Carpal Tunnel Syndrome. Isr Med Assoc J. 2023;25(7):507-510.
  • Li ZM, Jordan DB. Carpal tunnel mechanics and its relevance to carpal tunnel syndrome. Hum Mov Sci. 2023;87:103044.
  • Puledda F, Silva EM, Suwanlaong K, Goadsby PJ. Migraine: from pathophysiology to treatment. J Neurol. 2023;270(7):3654-3666.
  • Steiner TJ, Stovner LJ. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol. 2023;19(2):109-117.
  • Koyuncu, G. "Coexistence of Migraine and Carpal Tunnel Syndrome " Journal of Samsun Health Sciences 7(2), 2022: 407-418.
  • Wiberg A, Lucey MA, Kleeman S, Kang Y, Ng M, Furniss D. Genetic correlations between migraine and carpal tunnel syndrome. Plast Reconstr Surg. Published online August 18, 2023.
  • Gfrerer L, Chartier C, Lans J, Eberlin KR, Austen WG Jr. A Correlation between Upper Extremity Compressive Neuropathy and Nerve Compression Headache. Plast Reconstr Surg. 2021;148(6):1308-1315.
  • Gfrerer L, Lans J, Chartier C, Wenzinger E, Austen WG Jr, Eberlin KR. Migraine Headaches in Patients with Upper Extremity Compressive Neuropathy. Plast Reconstr Surg. 2022;150(6):1333-1339.
  • Guyuron B, Kriegler JS, Davis J, Amini SB. Comprehensive surgical treatment of migraine headaches. Plast Reconstr Surg. 2005 Jan;115(1):1-9.
  • Kung TA, Guyuron B, Cederna PS. Migraine surgery: a plastic surgery solution for refractory migraine headache. Plast Reconstr Surg. 2011;127:181–189.
  • Dodick DW, Turkel CC, DeGryse RE, Aurora SK, Silberstein SD, Lipton RB, et al.; PREEMPT Chronic Migraine Study Group. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010 Jun;50(6):921-36.
  • Janis JE, Hatef DA, Reece EM, McCluskey PD, Schaub TA, Guyuron B. Neurovascular compression of the greater occipital nerve: implications for migraine headaches. Plast Reconstr Surg. 2010 Dec;126(6):1996-2001.
  • Turkel CC, Aurora S, Diener HC, Dodick DW, Lipton RB, Silberstein SD, et al. Treatment of chronic migraine with Botox (onabotulinumtoxinA): Development, insights, and impact. Medicine (Baltimore). 2023 Jul 1;102(S1):e32600.
  • Baraldi C, Lo Castro F, Ornello R, Sacco S, Pani L, Guerzoni S. OnabotulinumtoxinA: Still the Present for Chronic Migraine. Toxins (Basel). 2023;15(1):59. Published 2023 Jan 10.
  • Law HZ, Amirlak B, Cheng J, Sammer DM. An Association between Carpal Tunnel Syndrome and Migraine Headaches-National Health Interview Survey, 2010. Plast Reconstr Surg Glob Open. 2015;3(3):e333. Published 2015 Apr 7.
  • La Pegna GB, Quatrosi G, Vetri L, Reina F, Galati C, Manzo ML, et al. Migraine and handedness. Neurol Sci. 2021;42(7):2965-2968. DOI:10.1007/s10072-021-05111-7
  • Tang QY, Lai WH, Tay SC. The Effect of Hand Dominance on Patient-Reported Outcomes of Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome. J Hand Surg Asian Pac Vol. 2017;22(3):303-308.
  • Blum ASS, Riggins NY, Hersey DP, Atwood GS, Littenberg B. Left- vs right-sided migraine: a scoping review. J Neurol. 2023;270(6):2938-2949.
There are 20 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Original Article
Authors

Güner Koyuncu 0000-0001-8772-472X

Early Pub Date August 30, 2024
Publication Date August 31, 2024
Submission Date April 14, 2024
Acceptance Date July 8, 2024
Published in Issue Year 2024 Volume: 34 Issue: 4

Cite

Vancouver Koyuncu G. Carpal Tunnel Syndrome and Migraine Lateralization. Genel Tıp Derg. 2024;34(4):536-41.