Carpal tunnel syndrome: age, nerve conduction severity and duration of symptomatology

Abstract

-Median sensory and motor distal latencies (SDL/MDL) were correlated with age and duration of symptomatology in 1498 carpal tunnel syndrome (CTS) patients (17-90 years old, 87.6% female). Patients were distributed in four groups according to distal latencies severity. There was an increase in age as long as SDL/MDL became more severe, ranging from 47.5 to 67 years old (mild to severe-absence potentials in both hands groups, respectively). There was a less dramatic increase in duration of complaints as long as SDL/ MDL became more severe, ranging from 12 to 30.7 months (mild to severe-absence potentials in both hands groups, respectively). Aging correlates more positively than duration of complaints with severity of SDL/ MDL in CTS. The effects of increasing median blockage in CTS are more severe as long as patients become older regardless duration of symptomatology.KEY WORDS: carpal tunnel syndrome, median nerve, entrapment neuropathy, compression neuropathy, nerve conduction study. Síndrome do túnel do carpo: correlação de idade, anormalidade de condução nervosa e tempo de sintomatologiaRESUMO -Latências distais sensitivas e motoras (LDS/LDM) do nervo mediano foram correlacionadas com idade e duração da sintomatologia em 1498 pacientes com síndrome do túnel do carpo (STC); a idade variou de 17 a 90 anos e 87,6% eram do sexo feminino. Os casos foram distribuídos em quatro grupos de acordo com a gravidade das latências distais. Houve aumento de idade proporcional ao aumento de LDS/LDM, variando de 47,5 a 67 anos nos grupos leve e grave-ausência de potenciais nas duas mãos, respectivamente. Houve aumento menos dramático na duração da sintomatologia proporcional ao aumento de LDS/LDM, variando de 12 a 30,7 meses nos grupos leve e grave-ausência de potenciais nas duas mãos, respectivamente. O aumento da idade correlaciona-se melhor que a duração da sintomatologia com o aumento de LDS/LDM. Os efeitos do aumento do bloqueio do nervo mediano no STC são mais graves com o avanço da idade, independentemente da duração da sintomatologia. PALAVRAS-CHAVE: síndrome do túnel do carpo, nervo mediano, neuropatia compressiva, condução nervosa.Carpal tunnel syndrome (CTS) is the most common nerve entrapment in upper extremities 1-3 . Median nerve is compressed in carpal tunnel, 2-4 cm distal to wrist groove where it passes togheter with nine flexor tendons; the thick transverse carpal ligament covers it and usually the focal demyelination occurs at the distal border.Nerve conduction studies have been used to assess nerve compression for more than 30 years 4,5 but unfortunately, in spite of many papers, little is known about nerve conduction severity, age and

Neurophysiologic Pattern and Severity Grading Scale of Carpal Tunnel Syndrome in Sudanese Patients

“…Also these compared favorably with the existing literature in regard to the classic history of CTS [10,15,16,24] with some discrepancies, as our severe and very severe grades of CTS showed considerably higher number of patients with obvious weakness and wasting of the APB muscles. This difference could be attributed to many factors: firstly as 66.6% of our patients are above 50 years, aging was found to account for the disease severity [10,11].…”

“…The majority of studies used different SNAP and CMAP parameters to provide a scale for grading the severity of CTS. Some used the conduction velocity, other used onset (distal) latency, peak latency and some used only the amplitude for grading the severity of CTS [14,15].…”

Evaluation of age, body mass index, and wrist index as risk factors for carpal tunnel syndrome severity

“…8,29 Axonal loss and vascular abnormalities associated with aging could increase peripheral nerve susceptibility to compression regardless of duration of symptomatology. 8,17,18,29 In conclusion, the presence of CTS was associated with increasing BMI and wrist index; more severe electrophysiological changes were associated with greater age and higher wrist index but not with BMI.…”

“…18 Personal factors such as age, body mass index (BMI, weight in kg/ height 2 in meters), and squarer wrist are also reported to be important risk factors. 7,8,18 Dieck and Kelsey, 5 after reviewing 40 CTS cases and 1,043 controls, identified a recent increase in body weight as a possible risk factor. Subsequently, Vessey et al, 27 studying 156 women with CTS in Oxford (out of a population of 17,032 women), found a statistically significant relationship between BMI and first consultation for CTS, and De Krom et al 4 found that obese persons had twice the risk for developing CTS than non-obese subjects.…”

Karpal Tünel Sendromu Hastalarında Elektrodiagnostik Evreleme ile Klinik Evre, Semptom Süresi ve Vücut Kitle İndeksi Arasındaki İlişkinin Değerlendirilmesi

“…Literatürdeki veriler sınırlı olmakla birlikte 27 çalışmamız, semptom süresi ile KTS şiddeti arasında belirgin ilişkinin saptandığı ve bu durumun yaşla birlikte belirgin bir risk faktörü olarak değerlendirildiği benzer bir çalışma ile uyumlu bulunmuştur 28 .…”