Carpal Tunnel Syndrome Research Today is a free monthly online journal that collates and summarizes the latest research about Carpal Tunnel Syndrome, including details on symptoms, causes, trauma, diagnosis, physiotherapy.

Neurophysiological study to assess the severity of each site though the motor neuron fiber in entrapment neuropathy.

Shibuya R, Kawai H, Yamamoto K

ABSTRACT: BACKGROUND: The double crush hypothesis (DCH) that had been widely accepted seems to have been dismissed recently. Prior to the DCH, retrograde changes in the proximal median nerve in carpal tunnel syndrome (CTS) were reported. There has been no report of quantitative analyzing about the effect of one site's compression on another site all through the same peripheral nerve in CTS patients. METHODS: We measured the central motor conduction time (CMCT), motor conduction latency of the cervical root region (CRL), peripheral path latency from the rootlet to the wrist (PL) and motor distal latency (MDL) in the median nerve and ulnar nerves, respectively in CTS patients. RESULTS: MDL, PL and CRL were prolonged selectively in the median nerve, but not in the ulnar nerve of CTS patients. And in the median nerve measurement, MDL was high (r=0.59, p<0.0001) while PL showed a significant (r=-0.28, p<0.05) relationship with CRL. MDL was large (r=0.58, p<0.0001) and showed a close (r=0.59, p<0.0001) relationship with the amplitude of CMAP. There was no significant difference between the amplitude of the normal CRL group and that of the prolonged CRL group. This quantitative analysis showed a linear relationship among MDL, CRL and CMAP amplitude. CONCLUSIONS: Dual entrapment lesions did not unexpectedly exaggerate the vulnerability or total damage. The vulnerability and the damage were proportional to the severity of each lesion.If the DCH term presented to an unexpectedly exaggerated degree, the cases of double crush symdrome in the CTS patients were rare, but if the term DCH refers to only this linear relationship, the DCH should not be dismissed.

Published 18 June 2009 in J Brachial Plex Peripher Nerve Inj, 4(1): 7.
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Articles on Carpal Tunnel Syndrome published 18 June 2009:

Differential involvement of A-delta and A-beta fibres in neuropathic pain related to carpal tunnel syndrome.   Pain.

Carpal tunnel syndrome (CTS), a common entrapment neuropathy involving the median nerve at the wrist, frequently manifests with neuropathic pain. We sought information on pain mechanisms in CTS. We studied 70 patients with a diagnosis of CTS (117 CTS hands). We used the DN4 questionnaire to select patients with neuropathic pain, and the Neuropathic Pain Symptom Inventory (NPSI) to assess the intensity of the various qualities of neuropathic pain. All patients underwent a standard nerve ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 17 June 2009:

Median nerve ultrasonography in carpal tunnel syndrome: Findings from two laboratories.   Muscle Nerve, 40(1): 94-97.

Ultrasonographic (US) enlargement of the median nerve at the wrist is known to be consistent with carpal tunnel syndrome (CTS), although the effects of different measurement techniques, equipment, and patient populations remain unknown. The purpose of this study was to examine the similarities and differences of US findings in CTS between two electromyography (EMG) laboratories. In 2006 and 2007, US measurements of the median nerve were recorded independently and statistically analyzed in ... [Abstract] [Full-text]

The Presence of Limited Joint Mobility Is Significantly Associated with Multiple Digit Involvement by Stenosing Flexor Tenosynovitis in Diabetics.   J Rheumatol.

OBJECTIVE: Diabetes is associated with several disorders of the hand, including stenosing flexor tenosynovitis (SFTS). The feature of SFTS in diabetics is a higher prevalence of multiple digit involvement. We examined the magnitude of the tendency for involvement of more digits by SFTS in diabetic patients than in nondiabetic patients, and attempted to clarify the factors influencing multiple digit involvement by SFTS in diabetics. METHODS: The study comprised 302 diabetic patients with SFTS ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 2 June 2009:

Nerve conduction studies in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.   J Neurol.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary cerebral microangiopathy linked to mutations in the Notch3 gene. The cerebral impairments of CADASIL are well-known, but peripheral nervous impairments such as polyneuropathy are less clear. Recently, peripheral neuropathy was proposed as one of the CADASIL phenotypes. We investigated peripheral nerve involvement in CADASIL patients. Forty-three CADASIL patients with confirmed ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 29 May 2009:

Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial.   J Pain, 10(6): 601-8.

We investigated the effectiveness of cupping, a traditional method of treating musculoskeletal pain, in patients with carpal tunnel syndrome (CTS) in an open randomized trial. n = 52 outpatients (58.5 +/- 8.0 years) with neurologically confirmed CTS were randomly assigned to either a verum (n = 26) or a control group (n = 26). Verum patients were treated with a single application of wet cupping, and control patients with a single local application of heat within the region overlying the ... [Abstract] [Full-text]

Sonography versus nerve conduction studies in patients referred with a clinical diagnosis of carpal tunnel syndrome.   J Clin Ultrasound.

PURPOSE.: To compare the diagnostic value of high-resolution ultrasound (US) with nerve conduction studies (NCS) in patients with clinically defined carpal tunnel syndrome (CTS). METHODS.: A prospective study was conducted on 66 consecutive patients investigated for sensory hand symptoms. The gold standard was the clinical diagnosis of CTS. RESULTS.: NCS showed greater diagnostic sensitivity (82%) than US (62%) in supporting a diagnosis of CTS. With increasing neurophysiologic severity of ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 28 May 2009:

Features at diagnosis of 324 patients with acromegaly did not change from 1981 to 2006; Acromegaly remains under-recognized and under-diagnosed.   Clin Endocrinol (Oxf).

Background: Traditionally, acromegaly evaded diagnosis until in its clinically obvious later stages when treatment is more difficult. Over the last 25 years diagnostic tests have improved, but whether clinical disease detection also improved was unknown so we tested if disease severity at diagnosis had changed from 1981 to 2006. Methods: Data on 324 consecutive acromegaly patients presenting from 1981-2006 at two New York City hospitals were collected by retrospective review (n=324) and by ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 27 May 2009:

Releasing the Tourniquet in Carpal Tunnel Surgery.   Hand (N Y).

The purpose of this study was to determine if letting down the tourniquet prior to closure after carpal tunnel release decreases the amount of post-operative ecchymosis and subsequent post-operative pain. We prospectively studied 18 consecutive patients who were undergoing bilateral open carpal tunnel releases. The side done first was randomized and the tourniquet was released to obtain hemostasis prior to closure on this side only. The second side was completed, closed, and dressed prior to ... [Abstract] [Full-text]

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