Carpal tunnel syndrome after an electrical injury: a case report and review of literature

Abstract

Introduction: Carpal tunnel syndrome (CTS) is prevalent in workers who utilize hand-held vibration tools, engage in tasks involving repetitive wrist movements, and suffer from wrist overuse. Although electrical injuries involving the median nerve are a relatively rare but plausible cause of CTS, the related literature is limited. Here, we report a case of CTS in which the symptoms developed after an electrical injury, and review the related literature. Case summary: The patient was a right-handed male electrician who often used hand tools but had no symptoms of CTS before the injury, with the left hand as the point of entry. Typical symptoms of CTS manifested after the electrical injury, and a nerve conduction velocity test confirmed the presence of severe CTS in the left hand. Therefore, we believe that the symptoms can be largely attributed to the electrical injury. Conclusions: The available literature supports the occurrence of delayed compressive neuropathy caused by scarring from substantial cutaneous burns in patients with electrical injuries. This case shows that electrical injuries may cause CTS in the absence of severe scarring through other mechanisms such as direct injuries to the nerve. Therefore, patients with electrical burns should be routinely examined for peripheral nerve compression symptoms in follow-ups, even when there are minimal cutaneous burns.

Neurological and neurourological complications of electrical injuries

“…Because electrical injuries are frequently occupational, the involvement of at least one hand in the task related to injury is usual. Consequently, median nerve compression and carpal tunnel syndrome are particularly possible [19]. Unfortunately, simultaneous immediate median and ulnar nerve palsy may also occur in the exposed upper limb while trineural (median, ulnar, and radial) injury has been also reported after a lowvoltage electrocution [20].…”

Carpal tunnel syndrome caused by tophi deposited under the epineurium of the median nerve: A case report

“…Carpal tunnel syndrome (CTS) is caused by compression of the median nerve as the most common upper limb peripheral nerve entrapment syndrome (1). Even though almost 50% of cases of CTS are idiopathic, recognized causes of CTS include tissue infiltration, tissue edema, tissue inflammation, hemorrhage after injury, and congenital variations, such as an abnormal muscle, tendon, or persistent median artery (2)(3)(4)(5)(6)(7)(8). In addition to the radiocarpal joint, the flexor tendons, tendon sheaths, and the carpal tunnel floor, gouty tophi deposits can accumulate in various structures, resulting in nontraumatic compression of the median nerve (2).…”