An Unusual Case of Median Neuropathy: Application of Short Segmental Sensory Nerve Stimulation
Summary: A 55-year-old woman presented with an 18-month history of intermittent left-hand paresthesias affecting her first, second, and third digits. A small, immobile, nontender midline mass on the volar aspect of the left wrist was also present. Evaluation included normal routine nerve conduction studies and needle electromyography. An ultrasound was performed in the electromyography laboratory, verifying median nerve involvement of the mass within the proximal carpal tunnel. This finding guided the electromyographer to perform the unconventional technique of sensory nerve short segmental stimulation across the carpal tunnel, which confirmed focal slowing across the lesion, achieving electrodiagnostic confirmation of median nerve impairment. This case of atypical carpal tunnel syndrome due to a median nerve schwannoma demonstrates both the utility and specificity of short segmental sensory stimulation in some cases of median neuropathy at the wrist and the value of sonography in the electromyography laboratory.
Authors: Sun PO, Schyns MVP, Walbeehm ET Abstract Carpal tunnel syndrome (CTS) is the most frequently operated neurological disorder of the hand. Incidence of patients remaining symptomatic has been reported up to 30% after primary release. Revision surgery remains challenging although multiple surgical options have been described. In this case series a simple novel technique, the palmaris longus interposition, is described for the treatment of recurrent and persistent CTS. Patients who underwent PLI between October 2013 and 2018 and without underlying neurological or hand disorders severely affecting the operated ...
Condition: Carpal Tunnel Syndrome Interventions: Drug: Insulin; Drug: Sodium Hyaluronate; Device: Ultrasound Sponsor: Assiut University Not yet recruiting
ConclusionThe ultrasound-guided percutaneous release of the carpal tunnel is demonstrated to be a procedure with a rapid learning curve.
Abstract Background: Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy in humans. Nonsurgical management is still a matter of debate, and conservative treatments include splinting, local steroid injections, ultrasound, and oral steroids. Acupuncture and electroacupuncture therapy for symptomatic CTS may improve symptoms and aid nerve repair as well as improve sensory and motor functions. However, limited evidence based on comprehensive evaluation methods is available regarding the effects of those treatments. Objective: The study intended to compare the short-term effects of acupuncture ...
Condition: Carpal Tunnel Syndrome Interventions: Procedure: Incisionless Threaded Carpal Tunnel; Procedure: Standard Mini-Open Carpal Tunnel Sponsor: Mayo Clinic Recruiting