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

Yıl 2022, Cilt 12, Sayı 6, 907 - 911, 30.11.2022
https://doi.org/10.16899/jcm.1166959

Öz

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.

Kaynakça

  • Genova A, Dix O, Saefan A, et al. Carpal tunnel Syndrome: A Review of Literature. Cureus 2020; 12(3): e7333. Doi: 10.7759/cureus.7333
  • Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 2011;44:597-607. doi: 10.1002/mus.22208.
  • Padua L, Coraci D, Erra C et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016;15:1273-84. doi: 10.1002/mus.22208
  • Chang CW, Wang YC, Chang KF. A practical electrophysiological guide for non-surgical and surgical treatment of carpal tunnel syndrome. J Hand Surg Eur Vol 2008; 33: 32–7
  • Padua L, Padua R, Lo Monaco M, Romanini E, Tonali P. Italian multicentre study of carpal tunnel syndrome: study design. Ital J Neurol Sci 1998;19:285-9. doi:10.1007/s100720050046
  • Padua L, Padua R, Lo Monaco M, Romanini E, Tonali P. For the Italian CTS Study Group. Multiperspective assessment of carpal tunnel syndrome. A multicenter study. Neurology 1999;53:1654-9. doi:10.1212/WNL.53.8.1654
  • Shin YH, Yoon JO, Kim YK, Kim JK. Prevalence of Anxiety and Depression Symptoms in People with Carpal Tunnel Syndrome. J Hand Surg Am 2018;43:484-8
  • Filho HRP, Pedroso FLC, Bueno FB, Paiva VGN, Oliveira EF, Rocha MA. Psychological Status is Associated with Symptom Severity in Patients with Carpal Tunnel Syndrome. Rev Bras Ortop 2020;55(4):438–44
  • Armutlu K, Korkmaz NC, Keser I et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research 2007;30(1):81-5.
  • Bennett M. The LANSS Pain Scale: the Leeds Assessment of Neuropathic Symptoms And Signs. Pain. 2001;92:147–57. Yücel A, Şenocak M, Kocasoy OE, Çimen A, Ertaş M. Results of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale in Turkey: a validation study. J Pain 2004;8:427–32.
  • Chen S, Andary M, Buschbacher R et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle and Nerve 2016;54:371-7. doi:10.1002/mus.25203
  • Fidancı H, Öztürk İ, Köylüoğlu AC, Yıldız M, Buturak Ş, Arlıer Z. The needle electromyography findings in the neurophysiological classification of ulnar neuropathy at the elbow. Turk J Med Sci 2020; 50(4): 804-810.
  • Katirji B. Peroneal neuropathy. Neurol Clin 1999;17:567-92.
  • Seddon HJ. A Classification of Nerve Injuries. Br Med J 1942; 2(4260): 237-239.
  • Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain 1951; 74(4):491-516
  • Hall B, Lee HC, Fitzgerald H, et al. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. Am J Occup Ther 2013;67:448–59.
  • Carpal Tunnel Syndrome: Making Evidence-Based Treatment Decisions. Orthop Clin North Am 2018; 49(2):223-229.

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

Yıl 2022, Cilt 12, Sayı 6, 907 - 911, 30.11.2022
https://doi.org/10.16899/jcm.1166959

Öz

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.

Kaynakça

  • Genova A, Dix O, Saefan A, et al. Carpal tunnel Syndrome: A Review of Literature. Cureus 2020; 12(3): e7333. Doi: 10.7759/cureus.7333
  • Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve 2011;44:597-607. doi: 10.1002/mus.22208.
  • Padua L, Coraci D, Erra C et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016;15:1273-84. doi: 10.1002/mus.22208
  • Chang CW, Wang YC, Chang KF. A practical electrophysiological guide for non-surgical and surgical treatment of carpal tunnel syndrome. J Hand Surg Eur Vol 2008; 33: 32–7
  • Padua L, Padua R, Lo Monaco M, Romanini E, Tonali P. Italian multicentre study of carpal tunnel syndrome: study design. Ital J Neurol Sci 1998;19:285-9. doi:10.1007/s100720050046
  • Padua L, Padua R, Lo Monaco M, Romanini E, Tonali P. For the Italian CTS Study Group. Multiperspective assessment of carpal tunnel syndrome. A multicenter study. Neurology 1999;53:1654-9. doi:10.1212/WNL.53.8.1654
  • Shin YH, Yoon JO, Kim YK, Kim JK. Prevalence of Anxiety and Depression Symptoms in People with Carpal Tunnel Syndrome. J Hand Surg Am 2018;43:484-8
  • Filho HRP, Pedroso FLC, Bueno FB, Paiva VGN, Oliveira EF, Rocha MA. Psychological Status is Associated with Symptom Severity in Patients with Carpal Tunnel Syndrome. Rev Bras Ortop 2020;55(4):438–44
  • Armutlu K, Korkmaz NC, Keser I et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research 2007;30(1):81-5.
  • Bennett M. The LANSS Pain Scale: the Leeds Assessment of Neuropathic Symptoms And Signs. Pain. 2001;92:147–57. Yücel A, Şenocak M, Kocasoy OE, Çimen A, Ertaş M. Results of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale in Turkey: a validation study. J Pain 2004;8:427–32.
  • Chen S, Andary M, Buschbacher R et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle and Nerve 2016;54:371-7. doi:10.1002/mus.25203
  • Fidancı H, Öztürk İ, Köylüoğlu AC, Yıldız M, Buturak Ş, Arlıer Z. The needle electromyography findings in the neurophysiological classification of ulnar neuropathy at the elbow. Turk J Med Sci 2020; 50(4): 804-810.
  • Katirji B. Peroneal neuropathy. Neurol Clin 1999;17:567-92.
  • Seddon HJ. A Classification of Nerve Injuries. Br Med J 1942; 2(4260): 237-239.
  • Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain 1951; 74(4):491-516
  • Hall B, Lee HC, Fitzgerald H, et al. Investigating the effectiveness of full-time wrist splinting and education in the treatment of carpal tunnel syndrome: a randomized controlled trial. Am J Occup Ther 2013;67:448–59.
  • Carpal Tunnel Syndrome: Making Evidence-Based Treatment Decisions. Orthop Clin North Am 2018; 49(2):223-229.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Şencan BUTURAK>
Adana City Training and Research Hospital, Department of Neurology
0000-0002-7496-5628
Türkiye


Halit FİDANCI> (Sorumlu Yazar)
Adana City Training and Research Hospital, Department of Neurology, Division of Clinical Neurophysiology
0000-0001-6573-9090
Türkiye


Ahmet Candan KÖYLÜOĞLU>
Adana City Training and Research Hospital, Department of Neurology
0000-0002-0795-0610
Türkiye


Mehmet YILDIZ>
Adana City Training and Research Hospital, Department of Neurology
0000-0002-0411-6794
Türkiye


Zülfikar ARLIER>
Adana City Training and Research Hospital, Department of Neurology
0000-0003-2645-648X
Türkiye

Erken Görünüm Tarihi 1 Ekim 2022
Yayımlanma Tarihi 30 Kasım 2022
Kabul Tarihi 5 Eylül 2022
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 6

Kaynak Göster

AMA Buturak Ş. , Fidancı H. , Köylüoğlu A. C. , Yıldız M. , Arlıer Z. The relationship between fatigue, neuropathic pain, and neurophysiological features in carpal tunnel syndrome. J Contemp Med. 2022; 12(6): 907-911.