REVIEW – August 2005

Carpal tunnel syndrome. Clinical and neurophysiological studies


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Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and is caused by compression of the median nerve at the wrist. Any condition that reduces the size of the carpal tunnel or increases the volume of its content will cause compression of the median nerve. The syndrome has gained increased recognition in recent years because of prominent attention to its occurrence in certain industrial settings, and it is currently one of the most commonly reported occupational diseases. Symptoms of CTS include (nocturnal) pain, paraesthesias and hypaesthesias in the hand, in the area innervated by the median nerve. Despite the importance of CTS, there are no universally accepted clinical and laboratory diagnostic criteria. It is commonly assumed, that certain electrodiagnostic abnormalities support the diagnosis. The estimated prevalence of clinically and elektrophysiologically confirmed CTS in the general population is 2,7%. To relieve the pressure on the median nerve, several treatment options, both surgical and conservative, are available. The most common conservative measures for the initial treatment is the local injections of corticosteroids. The injections recommended for the patients who remains symptomatic after conservative treatment with splinting and nonsteroidal anti-inflammatory drug therapy. Surgical treatment is widely preferred over nonsurgical therapies for severe CTS. In contrast, mild cases of CTS are usually not treated.