Atypical symptoms in carpal tunnel syndrome - treatment and results

Abstract

Additionally to the typical carpal tunnel symptoms, the patients of this study had atypical complaints. Other reasons for these symptoms than those caused by the compression of the median nerve could be excluded using medical examination or imaging techniques. Purpose of this study was to investigate whether decompression of the median nerve may reduce or even abolish the atypical complaints. For this prospective study 378 patients with carpal tunnel syndrome were clinically and electroneurographically examined, which was performed before and after (3 months) they underwent surgical decompression of the median nerve. 70 patients (19 % of all patients) with carpal tunnel symptoms suffered from additional atypical symptoms such as cardiac pain, ipsilateral headache as well as neck and shoulder pain. The diagnosis of carpal tunnel syndrome was made using clinical and electroneurographical examination. Carpal tunnel symptoms of all patients disappeared completely after surgery. Respectively, 61 % of those patients with preoperative atypical complaints did also fully recover. This study shows that patients with carpal tunnel syndrome may also suffer from atypical complaints. These symptoms have been shown to be associated with the compression of the median nerve. They may be caused by spinal synaptic interaction between sensory and sympathetic/parasympathetic neuronal pathways by somatically-induced reflex responses.