Investigation Of Coincidence of Idiopathic Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Neuropathy: Role of Cutaneous Silent Period

Abstract

The aim of this study was to investigate the coincidence of ulnar nerve entrapment neuropathy in idiopathic carpal tunnel syndrome (CTS) patients and the role of the cutaneous silent period (CSP) technique in detecting this association. Methods: A total of 42 patients referred to the Dr. Lutfi Kirdar Kartal Education and Research Hospital electromyography (EMG) laboratory with the initial diagnosis of carpal tunnel syndrome and 42 healthy age-and sex-matched volunteers were included in this cross-sectional study. Nerve conduction studies, needle EMG, and CSP measurement were performed on both groups. Results: In the group of 42 patients, 10 were male and 32 were female, with a mean age of 42.68±7.25 years, and the control group comprised 10 men and 32 women with a mean age of 35.58±8.35 years. A total of 68 hands in the patient group and 78 hands in the control group were examined. In all, 16 hands had mild CTS, moderate CTS was present in 47 hands, and 5 hands demonstrated severe CTS. Ulnar nerve entrapment neuropathy was observed in 3 of the 42 patients. Prolonged median sensory and motor distal nerve latency, reduction of sensory and motor action potential amplitudes, and slowing of conduction velocity were observed in nerve conduction studies of the CTS group. Median CSP latency was prolonged in the CTS group (p=0.000). Changes in median CSP duration and ulnar CSP latency and duration did not reach the level of statistical significance (p>0.05). There was no correlation between the severity of CTS and ulnar nerve entrapment neuropathy coincidence with the latency and duration of CSP. Conclusion: To the best of our knowledge, no previous study investigating ulnar CSP changes in CTS patients has been reported in the literature. The results of this research indicated that while CSP changes were detected in the CTS patients, CSP changes were not associated with the severity of CTS. There was no significant change in CSP parameters in patients with CTS and ulnar nerve entrapment neuropathy in the wrist.