Franka Claes1, Kristel M Kasius2, Jan Meulstee3, J André Grotenhuis4, Wim I M Verhagen3. 1. Department of Neurology, Vlietland Hospital, Schiedam, The Netherlands. Electronic address: claes.franka@gmail.com. 2. Department of Neurology, St Lucas Andreas Hospital, Amsterdam, The Netherlands. 3. Department of Neurology and Clinical Neurophysiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. 4. Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
BACKGROUND: Patients with complaints of carpal tunnel syndrome (CTS) with signs and symptoms not exclusively confined to the median nerve territory, but otherwise fulfilling the clinical criteria may erroneously be withheld from therapy. METHODS: One hundred and twenty one patients who fulfilled the clinical criteria for the diagnosis of CTS with signs and symptoms restricted to the median nerve territory (group A) and 91 patients without this restriction (group B) were included in a prospective cohort study. All patients fulfilled electrodiagnostic criteria of CTS. Outcome was determined after 7 to 9 months by means of Symptom Severity Score (SSS) and Functional Status Score (FSS) according to Levine and a patient satisfaction questionnaire. RESULTS: Response rates were 81.8% (group A) and 82.4% (group B). All patients in group B had sensory symptoms involving digit 5. There were no significant differences in improvement of SSS, FSS and patient satisfaction scores between groups after treatment. CONCLUSION: CTS patients with characteristic sensory signs and symptoms not exclusively restricted to the median nerve innervated area should be treated in the same manner as patients with CTS symptoms restricted to the median nerve innervated area and should therefore not be withheld from surgical treatment.
BACKGROUND:Patients with complaints of carpal tunnel syndrome (CTS) with signs and symptoms not exclusively confined to the median nerve territory, but otherwise fulfilling the clinical criteria may erroneously be withheld from therapy. METHODS: One hundred and twenty one patients who fulfilled the clinical criteria for the diagnosis of CTS with signs and symptoms restricted to the median nerve territory (group A) and 91 patients without this restriction (group B) were included in a prospective cohort study. All patients fulfilled electrodiagnostic criteria of CTS. Outcome was determined after 7 to 9 months by means of Symptom Severity Score (SSS) and Functional Status Score (FSS) according to Levine and a patient satisfaction questionnaire. RESULTS: Response rates were 81.8% (group A) and 82.4% (group B). All patients in group B had sensory symptoms involving digit 5. There were no significant differences in improvement of SSS, FSS and patient satisfaction scores between groups after treatment. CONCLUSION:CTSpatients with characteristic sensory signs and symptoms not exclusively restricted to the median nerve innervated area should be treated in the same manner as patients with CTS symptoms restricted to the median nerve innervated area and should therefore not be withheld from surgical treatment.
Authors: Floriaan G C M De Kleermaeker; Jan Meulstee; Franka Claes; Kristel M Kasius; Wim I M Verhagen Journal: J Neurol Date: 2017-10-09 Impact factor: 4.849