The relationship between fatigue, neuropathic pain, and neurophysiological features in carpal tunnel syndrome

Abstract

Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment mononeuropathy and can affect patients' daily living activities. In this study, it was aimed to find out whether there is a relationship between fatigue, neuropathic pain and neurophysiological features in CTS. Material and Method: Patients with clinical features compatible with CTS were included in this retrospective study. Median nerve compound muscle action potential (CMAP) and compound nerve action potential (CNAP) of the patients were analyzed. The Turkish version of the Fatigue Severity Scale (FSS) was administered to all patients. Patients with a mean FSS score of ≥4 were considered to have fatigue. In addition, Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) was applied to some patients. If the LANSS score was 12 or higher, these patients were considered to have neuropathic pain. Results: Thirty-two female and eight male CTS patients were included in the study. Thirty-two patients had clinically bilateral CTS and eight patients had right-sided CTS. FSS and LANSS were administered to 40 and 18 patients, respectively. There were 29 CTS patients (72.5%) with an FSS score ≥ 4. CNAP/CMAP amplitudes and sensory/motor nerve conduction velocities of patients with fatigue were lower than those without fatigue (p<0.05). Neuropathic pain was present in 9 (100%) and 4 (44%) patients with and without fatigue, respectively (p=0.029). Conclusion: This study indicated that there may be an association between fatigue, neuropathic pain and nerve conduction study findings in CTS.

Keywords

• Carpal tunnel syndrome
• fatigue
• nerve conduction study
• neuropathic pain

Karpal tünel sendromunda yorgunluk, nöropatik ağrı ve nörofizyolojik özellikler arasındaki ilişki

Abstract

Giriş: Karpal tünel sendromu (KTS) en sık görülen tuzak mononöropatidir ve hastaların günlük yaşam aktivitelerini etkileyebilir. Bu çalışmada KTS'de yorgunluk, nöropatik ağrı ve nörofizyolojik özellikler arasında bir ilişki olup olmadığının ortaya çıkarılması amaçlanmıştır. Gereç ve Yöntem: Bu retrospektif çalışmaya klinik özellikleri KTS ile uyumlu olan hastalar dahil edildi. Hastaların median sinir bileşik kas aksiyon potansiyeli (BKAP) ve bileşik sinir aksiyon potansiyeli (BSAP) analiz edildi. Tüm hastalara Yorgunluk Şiddet Ölçeği'nin (YŞÖ) Türkçe versiyonu uygulandı. Ortalama YŞÖ skoru ≥4 olan hastalar yorgunluk olarak kabul edildi. Ayrıca bazı hastalara Leeds Nöropatik Semptom ve Belirti Değerlendirmesi (LANSS) uygulandı. LANSS skoru 12 ve üzeri ise bu hastalarda nöropatik ağrı olduğu kabul edildi. Bulgular: Çalışmaya 32 kadın ve sekiz erkek KTS hastası dahil edildi. Otuz iki hastada klinik olarak bilateral KTS ve sekiz hastada sağ taraflı KTS vardı. Sırasıyla 40 ve 18 hastaya YŞÖ ve LANSS uygulandı. YŞÖ skoru ≥ 4 olan 29 KTS hastası (%72.5) vardı. Yorgunluğu olan hastaların BSAP/BKAP amplitüdleri ve duyu/motor sinir iletim hızları, olmayanlara göre daha düşüktü (p<0.05). Nöropatik ağrı, yorgunluk olan ve olmayan sırasıyla 9 (%100) ve 4 (%44) hastada mevcuttu (p=0.029). Sonuç: Bu çalışma, KTS'de yorgunluk, nöropatik ağrı ve sinir iletim çalışması bulguları arasında bir ilişki olabileceğini göstermiştir.

Keywords

• Karpal tünel sendromu
• yorgunluk
• sinir iletim çalışması
• nöropatik ağrı

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