Evaluation clinical and electrophysiological findings in carpal tunnel syndrome

Introduction and Objective: In this study, we aimed to reevaluate and explicate the etiological factors, demographic and clinical features and electrophysiological findings of the patients, who were referred to the Policlinic of the Department of Neurology of the School Of Medicine of Çukurova University, with the symptoms consisting of numbness of hands, paresthesia, tingling sensation and pain localized to hand, antebrachial or brachial regions and with the initial diagnotic impression of ?carpal tunnel syndrome? (CPS). Material and Methods: 60 patients with the initial diagnostic impression of carpal tunnel syndrome were enrolled in the study, based upon their medical history. To evaluate the demographical and etiological factors properly, a detailed anamnesis of the patients were taken which covered the age, sex, dominant hand, height, weight, body mass index (BMI), present symptoms, duration of symptoms, the hand inwhich the first symptoms were observed, personal and familial medical histories and medication history by the use of CTS evaluation forms. Medical conditions, roles of which are established in the CTS pathogenesis, are evaluated via biochemical and hematological tests (i.e., hemogram, fasting blood glucose, thyroid function tests, Hemoglobin A1C). After evaluation with CTS forms and clinical examination, nerve conduction in the patients? bilateral upper extremities were evaluated via the use of surface electrodes. Findings: According to the electrophysiological findings, we observed that 66:7% of the 60 patients with the initial diagnosis of CTS, had CTS.42:5% of these patients had bilateral CTS. Female gender, obesity, high BMI, old age and repetetive hand movements were observed risk factors. Also, there was a high incidence of CTS in the patients with Diabetes Melliyus (DM) and pregnant women. The definitive diagnosis for CTS is established only with EMG-ENG studies. To establish the CTS diagnosis during the subclinical phase, both hands should be evaluated by EMG-ENG. Conclusion: Female gender, obesity, high BMI, old age and repetitive hand movements seem to play an important role in the pathogenesis of CTS. Diagnosis of CTS is established by anamnesis, physical examination, electrophysiological and other laboratory tests. The most observed symptom is numbness. Another quite common symptom is paresthesia. In the presence of these symptoms, muscle atrophy and positive results tı provacative tests are valuable to establish the diagnosis. It is very important to keep in mind that during the subclinical phase, it is only possible to establish a CTS diagnosis via EMG, so during this phase, EMG-ENG must be performed for both of the upper extremities. Key words: Atrophy, Elektromyelografi, Median Nerve, Paresthesia, Carpal Tunnel Sendroumu