Autonomic dysfunction in idiopathic carpal tunnel syndrome

Evaluation of Sympathetic Vasomotor Fibres in Carpal Tunnel Syndrome Using Continuous Wave Doppler Ultrasonography

“…The mean maximal recorded value of the pulsatility index from the three readings from each artery was used for data analysis. Subjects in both groups were assessed for the 'presence' or 'absence' of the following autonomic symptoms, according to Vergehese et al (2000): swelling of the hand, dry palms, blanching of the fingers, nail changes, fingertip ulceration and Raynaud's phenomenon.…”

“…This may limit the routine use of Doppler ultrasonography as a diagnostic test in the work up of CTS in a small proportion of patients. Vergehese et al (2000) reported that autonomic symptoms were present in 55% of their series and that swelling of the fingers and dry palms were the commonest autonomic symptoms. In a series reported by Tanzer (1959), vasomotor disturbances, including colour changes in the skin, mild degrees of oedema and excessive sweating were present in 15 out of 25 cases of CTS.…”

“…Although the sympathetic vasomotor fibres of the median nerve and ulnar nerve supply the areas of their respective territories (Campero et al, 1993), the median nerve carries with it the main sympathetic vasomotor supply of the hand (Woollard and Philips, 1932). It is recognized that autonomic symptoms are present in the territory of the median nerve in carpal tunnel syndrome (CTS) (Tanzer, 1959;Vergehese et al, 2000). While large diameter sensorimotor fibre dysfunction has been extensively studied in CTS (Fudley Porras et al, 2000;Robinson et al, 2000;Werner and Andary, 2002), few studies have investigated autonomic dysfunction.…”

EMG vs. Thermography in Severe Carpal Tunnel Syndrome

“…Yarnitsky and Ochoa claim that symptoms, which potentially belong to the autonomous nervous system disorder (finger sweating, dry palms, Raynaud's phenomenon, and finger pallor), can only be noticed in 17% to 32% of patients with CTS, and don't have high diagnostic value (Yarnitsky & Ochoa, 1991). But on the contrary, Verghese and others point out that the involvement of autonomous nervous system in CTS is frequent (55%), especially in the group of people with severe neurophysiological level of entrapment (Verghesse et al, 2000). The results of our research are in line with the latter; as a matter of fact, the classification was by far the most successful in the group with the most severe level of entrapment in terms of electrodiagnostics (Table 3).…”

“…Our neural network was used on a group of patients with predominantly bilateral impairment, and the threshold for successful classification was set at 80%. The assessment of the autonomous nervous system, in MN entrapment, was evidenced only by few authors (Aminoff, 1979;Verdugo et al, 2004;Verghesse et al, 2000). As a matter of fact, the incidence of these symptoms is not completely clear both in healthy people and in people with some other hand pathology.…”