Selective Motor Neuropathy of the Median Nerve Caused by a Ganglion in the Carpal Tunnel

Crowley, B; Gschwind, C.; Storey, Catherine E.

doi:10.1016/s0266-7681(98)80013-2

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…However, due to anatomical variations of the recurrent branch, it may be compressed in the distal portion of the carpal tunnel [2,7,13]. Paralysis of APB may be the main presenting symptom in patients with CTS, suggesting that anatomical variations of the recurrent motor branch occur frequently, and that the motor branch to APB may only be affected [2,4,15]. Inadequate release of the transverse ligament may be the cause of a poor outcome after surgery [5,11,14].…”

Section: Resultsmentioning

confidence: 99%

Endoscopic carpal tunnel release and nerve conduction studies

Ueno

Taguchi

Fuchigami

et al. 2001

International Orthopaedics

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We investigated the outcome of endoscopic carpal tunnel release (ECTR) for patients with carpal tunnel syndrome (CTS) in comparison with the results of preoperative nerve conduction studies. The compound muscle action potential (CMAP) of the abductor pollicis brevis muscle (APB) and the second lumbrical muscle (L2) was recorded following median nerve stimulation at the wrist. A total of 38 hands in 35 patients were classified into four categories. Hands with a similarly prolonged distal motor latency for the APB and L2 were classified as type 1 (n=25), while those with a more prolonged distal motor latency for the APB than for the L2 (>0.7 ms) were classified as type 2 (n=10). Hands with a CMAP for the APB, but not L2, were classified as type 3 (n=1), and hands with no CMAP for either the APB or L2 were classified as type 4 (n=2). After ECTR, all of the type 1 and 2 hands were improved. Patients with type 3 and type 4 hands did not show satisfactory improvement, which may have been due to anatomical variation of the recurrent motor branch of the median nerve.Résumé Nous avons examiné la réaction à des opéra-tions de libération du canal carpien endoscopique (LCCE) chez des patients souffrant d'un syndrome du canal carpien (SCC), en utilisant les résultats d'une etude de conduction des nerfs (ECN) préopératoire. La ré-action des potentiels de l'action des muscles composés (PAMC) de l'abducteur pollicis brevis (APB) et du second muscle lombrical (L2) fut enregistrée suivant une stimulation du nerf médian au poignet. Un total de 38 mains de 35 patients fut divisé en quatre catégories. Les mains avec SCC présentant une latence motrice distale prolongée similaire dans APB et L2, furent classées en tant que type 1 (25 mains). Celles avec SCC présentant une latence motrice distale plus prolongée dans APB que dans le L2 (>0.7 ms), furent classées en tant que type 2 (10 mains), celles avec SCC dont les PAMC de APB seuls furent mis en lumiére, furent classées en tant type que 3 (1 main), et celles avec SCC dont les PAMC à la fois de APB et L2 ne furent pas mis en lumière, furent classées en tant que type 4 (2 mains). Après la LCCE, toutes les mains des types 1 et 2 furent bien améliorées. Patients de types SCC 3 et 4 n'ont pas pré-senté une amélioration satisfaisante, par suite probablement d'une variation anatomique d'une branche motrice récurrente. IntroductionIt has been reported that endoscopic carpal tunnel release (ECTR) gives mostly satisfactory results in the treatment of carpal tunnel syndrome (CTS). There are some unsatisfactory results, however. We classified CTS according to the degree of involvement of the recurrent motor branch of the median nerve, based on nerve conduction velocity (NCV) studies, and report the results and the indications for ECTR in patients with CTS. Patients and methodsWe studied 38 hands in 35 patients, with symptoms of carpal tunnel syndrome by ECTR. There were five men and 30 women with a mean age of 66 years (31-83 years). The mean follow-up period was 8 months (3-32 months).W...

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Section: Resultsmentioning

confidence: 99%

Endoscopic carpal tunnel release and nerve conduction studies

Ueno

Taguchi

Fuchigami

et al. 2001

International Orthopaedics

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“…14 -16 Despite the more common use of MRI in the evaluation of hand masses ultrasonography may be helpful in its ability to trace the cyst to its joint of origin. 11,14 In both cases presented here the MRI identified correctly the mass as a cyst but failed to localize precisely the proximal extent of the stalk.…”

Section: Discussionmentioning

confidence: 76%

“…In some such cases a mass can be felt in the proximal palm at the base of the thenar eminence. 9,11,12 Similarly, ganglions arising from intercarpal joints can cause compression of the ulnar nerve in Guyon's canal with or without an associated palpable mass. 5,13,14 Rarely ganglions present as masses in the palm without associated symptoms or findings of nerve compression.…”

Section: Discussionmentioning

confidence: 99%

“…28 Ganglion from the wrist should be included in the differential diagnosis of a painless mass in the palm. Preoperative identification of a ganglion can be aided by ultrasonography 10,11,14 or MRI. 14 -16 Despite the more common use of MRI in the evaluation of hand masses ultrasonography may be helpful in its ability to trace the cyst to its joint of origin.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Wrist joint ganglion presenting as a painless mass in the palm: report of 2 cases

Cornwall

Koris

Jupiter

2004

The Journal of Hand Surgery

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“…The most important finding of the current investigation is that the TMB of the median nerve can be identified consistently with the use of currently available, high‐frequency US transducers. Consequently, evaluation of the TMB could be included in CTS US imaging protocols, and sonographic evaluation of the TMB should be considered in patients with unexplained or disproportionate thenar atrophy or who have persistent or new symptoms or signs after carpal tunnel release [26,41,42,44,47‐50,53‐55]. Furthermore, as clinically indicated, preoperative sonographic localization of the TMB may mitigate risk in patients being considered for endoscopic or minimally invasive carpal tunnel releases, including ultrasound‐guided carpal tunnel release [5,7,15,16,33,56‐65].…”

Section: Discussionmentioning

confidence: 99%