Migren ile Karpal Tünel Sendromu Birlikteliği

Year 2022, Volume: 7 Issue: 2, 407 - 418, 29.08.2022

Güner Koyuncu

https://doi.org/10.47115/jshs.1039119

Cited By: 1

Abstract

Amaç: Migren ve karpal tünel sendromu (KTS), toplumda sık rastlanılan iki ayrı hastalık tablosudur. Birbirinden tamamen farklı olan bu iki tablonun bazı ortak özelliklere sahip olduğu dikkatimizi çekmiştir. Bu yüzden bu iki tablonun birlikteliği var mıdır? Var ise bu birliktelik anlamlı mıdır? Sorularına cevap bulmak amacı ile bu çalışma planlanmıştır.
Yöntem: Bu çalışma 178 KTS ve 167 migren olmak üzere toplam 345 hasta ile yürütüldü. Çalışmada iki grup oluşturuldu. Birinci grup, elektrofizyoloji laboratuvarında KTS tanısı konulan hastalardan oluştu. Bu hastalara uluslararası baş ağrısı sınıflama kriterlerine göre hazırlanan migren tarama anketi yapıldı. Bu ankete göre hastalarda migreni olanlar ve olmayanlar belirlendi. İkinci grup ise nöroloji polikliniğine başvuran ve migren tanısı konulan hastalardan oluşturuldu. Bu grup ise migren grubu olarak adlandırıldı. Bu çalışma kesitsel ve karşılaştırmalı olarak dizayn edildi.
Bulgular: Dışlama kriterleri sonrası çalışmada kalan toplam 345 hastanın 178’i KTS grubunda, 167’si migren grubunda idi. KTS hastalarının %80,3'ünde migren saptanırken, migren olanların %12,6'sında KTS saptandı.
Sonuç ve Öneriler: Bulduğumuz KTS grubunda yüksek oranda migren, migren grubunda ise düşük oranda KTS saptanmış olması, migren baş ağrılarının gelecekte KTS olmaya yatkınlık oluşturabileceği yargısını doğurdu. Bu görüşümüzü desteklemek için ek çalışmalara ihtiyaç olduğu kanaatindeyiz.

Keywords

Karpal tünel sendromu, Migren, Patofizyoloji, Sıklık, Komorbidite

Coexistence of Migraine and Carpal Tunnel Syndrome

Abstract

Aim: Migraine and carpal tunnel syndrome (CTS) are two common health problems that have some common features and are frequently encountered in society. Is it possible for these two tables, which have so much in common, to coexist? If so, is this association meaningful? The study was designed in order to find answers to these questions.
Method: This study was performed with a total of 345 subject as 178 patients having carpal tunnel syndrome (CTS) and 167 migraine patients. The first group was composed of those diagnosed with CTS based on the nerve conduction measurements in the electrophysiology laboratory. These patients were classified according to the international headache classification criteria and those with and without migraine were determined in the light of the data in the questionnaire. The second group, called as migraine group, comprised of those admitted to the neurology outpatient clinic and diagnosed with migraine. The study was designed as a cross-sectional and comparative study.
Results: Of the 345 patients who remained in the study after exclusion criteria, 178 were in the CTS group and 167 were in the migraine group. Although approximately 80,3% of those with CTS had migraine, only 12,6% of those diagnosed with migraine had CTS.
Conclusion and Suggestions: We consider that migraine headaches may create a predisposition to contract CTS in the future. Additional studies are needed to support this view.

Keywords

Carpal Tunnel Syndrome, Comorbidity, Migraine, Physiopathogenesis, Frequency

References

• Aboonq MS. Pathophysiology of the carpal tunnel syndrome Neurosciences (Riyadh) 2015;20(1):1-9.
• Costigan M, Moss A, Latremoliere A, et al.. T-cell infiltration and signaling in the adult dorsal spinal cord is a major contributor to neuropathic pain-like hypersensitivity. Version 2. J Neurosci. 2009 18;29(46):14415-22. doi: 10.1523/JNEUROSCI.4569-09.2009.
• Di Renzo L, Cammarano A, De Lorenzo A. J The missclassification of obesity affects the course of migraine. Headache Pain. 2018;19(1):63. doi: 10.1186/s10194-018-0895-6.
• Etminan M, Takkouche B, Isorna FC, Samii A. Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies. BMJ. 2005:8;330(7482):63. doi: 10.1136/bmj.38302.504063.8F
• Faithfull DK, Moir DH, Ireland J. (1986) The micropathology of the typical carpal tunnel syndrome. J Hand Surg Br. 11(1),131-2. doi: 10.1016/0266-7681(86)90035-5.
• Festen-Schrier VJMM, Amadio PC. (2018). The biomechanics of subsynovial connective tissue in health and its role in carpal tunnel syndrome. J Electromyogr Kinesiol. 38,232-239. doi: 10.1016/j.jelekin.2017.10.007.
• Freeland AE, Tucci MA, Barbieri RA, Angel MF, Nick TG. Biochemical evaluation of serum and flexor tenosynovium in carpal tunnel syndrome. Microsurgery. 2002;22(8):378-85. doi: 10.1002/micr.10065.
• Fuchs PC, Nathan PA, Myers LD. (1991). Synovial histology in carpal tunnel syndrome. J Hand Surg Am. 16(4),753-8. doi: 10.1016/0363-5023(91)90208-s. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol. 1990;28(2):183-7. doi: 10.1002/ana.410280213
• Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version) Cephalalgia . 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658.
• Hirata H, Nagakura T, Tsujii M, Morita A, Fujisawa K, Uchida A. The relationship of VEGF and PGE2 expression to extracellura matrix remodelling of tenosynovium in the carpal tunnel syndrome. J Pathol. 2004;204:605-612. doi: 10.1002/path.1673.
• Holzer P. Neurogenicvasodilatation and plasma leakage in the skin. Gen Pharmacol. 1998;30(1):5-11. doi: 10.1016/ s0306-3623(97)00078-5.
• Jablecki CK, Andary MT, So YT, Wilkins E, Williams FH, Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee. Muscle Nerve. 1993;16(12):1392-414. doi: 10.1002/mus.880161220.
• Jablecki CK, Andary MT, Di Benedetto M, et al. American Association of Electrodiagnostic Medicine guidelines for outcome studies in electrodiagnostic medicine. Muscle Nerve. 1996;19(12):1626-35. doi: 10.1002/(SICI)1097- 4598(199612)19:12<1626::AID-MUS18>3.0.CO;2-P.
• Jacobs B, Dussor G, Neurovascular contributions to migraine. Neuroscience. 2016;3;338:130-44 doi: 10.1016/j. neuroscience.2016.06.012.
• Jeremy D.P Jeremy D P Bland. (2007). Carpal tunnel syndrome. BMJ. 335(7615), 343–346. doi: 10.1136/ bmj.39282.623553.AD.
• Kerr CD, Sybert DR, Albarracin NS. An analysis of the flexor synovium in idiopathic carpal tunnel syndrome: report of 625 cases. J Hand Surg Am. 1992;17(6):1028-30. doi: 10.1016/s0363-5023(09)91053-x.
• 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. 2015:7;3(3):e333. doi: 10.1097/GOX.0000000000000257.
• Li C, Zhu Q, He Q, Wang J, Wang F, Zhang H. Plasma Levels of Cyclooxygenase-2 (COX-2) and Visfatin During Different Stages and Different Subtypes of Migraine Headaches. Med Sci Monit. 2017 Jan 3;23:24-28. doi: 10.12659/msm.899269
• Lluch AL. (1992). Thickening of the synovium of the digital flexor tendons: cause or consequence of the carpal tunnel syndrome? J Hand Surg Br. 17(2), 209-12. doi: 10.1016/0266-7681(92)90091-f.
• MacClellan LR, Giles W, Cole J, et al. Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke. 2007;38(9):2438-45. doi: 10.1161/STROKEAHA.107.488395.
• Menke W, Palme E, Matheus M, Schmitz B, Michiels I. (1994) [Results of histological studies of the flexor tendon sheath in 35 flexor tenosynovectomies in carpal tunnel syndrome]. Z Orthop Ihre Grenzgeb. 132(2),126-8. doi: 10.1055/s-2008-1039830.
• Messlinger K, Fischer MJ, Lennerz JK. [Neuropeptide effects on the trigeminal system: pathophysiology and clinical significance for migraine]. Schmerz. 2011;25(4):393-8, 400-1. doi: 10.1007/s00482-011-1069-5.
• Nakamichi K, Tachibana S. (1998) Histology of the transverse carpal ligament and flexor tenosynovium in idiopathic carpal tunnel syndrome. J Hand Surg Am. 23(6),1015-24. doi: 10.1016/s0363-5023(98)80009-9.
• Neal NC, McManners J, Stirling GA. Pathology of the flexor tendon sheath in the spontaneous carpal tunnel syndrome.J Hand Surg Br. 1987;12(2):229-32. doi: 10.1016/0266-7681(87)90020-9.
• Rasmussen BK, Jensen R, Schroll M, Olesen J.et al. Epidemiology of headache in a general population--a prevalence study. J Clin Epidemiol. 1991;44(11):1147-57. doi: 10.1016/0895-4356(91)90147-2.
• Sacco S, Ripa P, Grassi D, et al. Peripheral vascular dysfunction in migraine: a review. J Headache Pain. 2013:1;14(1):80. DOI: 10.1186/1129-2377-14-80
• Schmid AB, Nee RJ, Coppieters MW. Reappraising entrapment neuropathies--mechanisms, diagnosis and management. Man Ther. 2013;18(6):449-57. doi: 10.1016/j.math.2013.07.006.
• Schmid AB, Coppieters MW, Ruitenberg MJ, McLachlan EM. Local and remote immune-mediated inflammation after mild peripheral nerve compression in rats. J Neuropathol Exp Neurol. 2013;72(7):662-80. doi: 10.1097/NEN.0b013e318298de5b.
• Scelsi R, Zanlungo M, Tenti P. (1989).Carpal tunnel syndrome. Anatomical and clinical correlations and morphological and ultrastructural aspects of the tenosynovial heath. Ital JOrthop Traumatol. 15(1), 75-80
• Shum C, Parisien M, Strauch RJ, et al. J Bone Joint Surg Am. 2002 The role of flexor tenosynovectomy in the operative treatment of carpal tunnel syndrome. Feb;84(2):221-5. doi: 10.2106/00004623-200202000-00009.
• Steiner TJ, Stovner LJ, Birbeck GL. Migraine: the seventh disabler. J Headache Pain. 2013:10;14(1):1. doi: 10.1186/1129-2377-14-1
• Tecchio F, Padua L, Aprile I, Rossini PM. Carpal tunnel syndrome modifies sensory hand cortical somatotopy: a MEG study. Hum Brain Mapp. 2002;17(1):28-36. doi: 10.1002/hbm.10049.
• Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012:15;380(9859):2163- 96. doi: 10.1016/S0140-6736(12)61729-2.
• Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-15. DOI: 10.1016/j.pain.2010.09.030
• Zanette G, Cacciatori C, Tamburin S. Central sensitization in carpal tunnel syndrome with extraterritorial spreadof sensory symptoms. Pain. 2010;148(2):227-36. doi: 10.1016/j.pain.2009.10.025