Prognosis of severe carpal tunnel syndrome with absent compound muscle action potential

Kamiya, Hisao; Kimura, Michio; Hoshino, Satoshi; Kobayashi, Masahito; Sonoo, Masahiro

doi:10.1002/mus.25004

Cited by 13 publications

(14 citation statements)

References 17 publications

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“…Two of the largest previous studies carried out univariate analyses of the predictive value of NCS in 460 operations 7 and in 465 operations, 8 with both concluding that NCSs have no predictive value. Other prior studies have reached contradictory conclusions, some claiming that more severe abnormalities are associated with a better prognosis, 9 some claiming the converse, 10 and others claiming that they have no relationship with prognosis at all. 11 Both of our models confirm our previous finding that patients with neurophysiological abnormalities in the middle of the Canterbury severity scale have the best prognosis.…”

Section: Discussionmentioning

confidence: 98%

A prognostic model for the patient‐reported outcome of surgical treatment of carpal tunnel syndrome

et al. 2018

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Section: Discussionmentioning

confidence: 98%

A prognostic model for the patient‐reported outcome of surgical treatment of carpal tunnel syndrome

et al. 2018

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“…Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the median nerve ( 1 ), but evaluating the severity of CTS (especially thenar muscle dysfunction) is associated with some uncertainty ( 2 ). The thenar muscles play a very important role in efficient hand function.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of thenar muscles by MRI in carpal tunnel syndrome

Dilokhuttakarn¹,

Naïto²,

Kinoshita³

et al. 2017

Experimental and Therapeutic Medicine

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In the present study, the thenar muscles were evaluated using magnetic resonance imaging (MRI), in addition, the correlations between thenar muscle changes, clinical findings and electrodiagnostic results from patients with carpal tunnel syndrome were investigated. The subjects were 13 patients (17 wrists) who were clinically diagnosed with carpal tunnel syndrome. In all patients, a medical history was obtained and physical examination was performed, in addition to assessment using the Kapandji scoring system, visual analogue scale (VAS), quick-disabilities of the arm, shoulder and hand (Q-DASH) score, electrodiagnostic results of the median nerve, and MRI of the thenar muscles. Thenar muscle volume was not significantly correlated with clinical data or the electrodiagnostic results. The thenar muscle major axis was significantly correlated with grasp power (P<0.05) and the Kapandji score (P<0.05), while the thenar muscle minor axis was significantly correlated with abductor pollicis brevis distal motor latency (APB DML) (P<0.01). In addition, the thenar muscle minor axis/thenar muscle major axis ratio was significantly correlated with APB DML and Kanatani's stage. Notably, thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes, while the grasp power and Kapandji score were correlated with thenar muscle thickness. Furthermore, it was demonstrated that thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes; in addition, there was a significant correlation between the thenar muscle major axis and the grasp power or Kapandji score. Taken together, these results revealed that thenar muscle atrophy did not affect patient-based assessments, including VAS and Q-DASH, but reflected electrodiagnostic results, particularly DML and severity. The results of the present study suggest that thenar muscle atrophy can be used to estimate the severity of carpal tunnel syndrome.

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“…Delays in diagnosis can lead to finger contracture and an irreversible axon injury of nerve. [11,14] …”

Section: Discussionmentioning

confidence: 99%

A repeated carpal tunnel syndrome due to tophaceous gout in flexor tendon

2017

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Rationale:Gouty tophi is a rare cause of CTS. We first report a unique case of repeated CTS with gouty tophi in flexor tendon. In the previous literature, the symptoms cases of CTS were gradually increased.Patient concerns:We report a 44-year-old male porter presented with mass on his left distal forearm combined a repeated carpal tunnel syndrome for 5 years. He felt numbness in fingers and his left palmar. The CTS symptoms had been eased through rest and dugs medication. It recurred twice.Diagnoses:Monosodium urate crystal deposits were found in surgery. Histologic findings confirmed the diagnosis of gout.Interventions:We removed partial of gouty tophus and retained the integrity of the tendon.Outcomes:Two years after the surgery, the patient had not experienced any symptom recurrence.Lessons:Early diagnosis and control of gout are necessary to avoid irreversible complications. The surgery combined with decreasing trioxypurine treatment can improve the treatment outcome of gouty tophus.

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Prognosis of severe carpal tunnel syndrome with absent compound muscle action potential

Abstract: Prolonged 2L-DML and absent 2L-CMAP seem to be poor prognostic factors. Concurrent opponensplasty may not be necessary in patients with 2L-DML of 8 ms or less. Muscle Nerve 54: 427-431, 2016.

Cited by 13 publications

References 17 publications

A prognostic model for the patient‐reported outcome of surgical treatment of carpal tunnel syndrome

A prognostic model for the patient‐reported outcome of surgical treatment of carpal tunnel syndrome

Evaluation of thenar muscles by MRI in carpal tunnel syndrome

A repeated carpal tunnel syndrome due to tophaceous gout in flexor tendon

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