Carpal Tunnel Syndrome in Patients with Tremor Dominant Parkinson's Disease.

Sang Won Han,Jeong Yeon Kim,Kyeong Yeol Cheon,Jong Sam Baik,Oscar Arias-Carrion

doi:10.1371/journal.pone.0130779

Sang Won Han, Jeong Yeon Kim + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0130779

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Journal: PloS one	Publication Date: Jun 19, 2015
Citations: 6	License type: CC BY 4.0

Affiliation: Inje University Sanggye Paik Hospital

Abstract

BackgroundUnilateral hand tremor is one of the cardinal symptoms of Parkinson’s disease. Additionally, mechanical traumatic hand movement is one of the risk factors for carpal tunnel syndrome. Our objective in this study was to examine whether repetitive mechanical movement may be related to the development of carpal tunnel syndrome in Parkinson’s disease with unilateral hand tremor using neurophysiological methods.MethodsThe study participants included 33 de novo Parkinson’s disease patients with unilateral hand tremor, and we compared the tremor hand and non-tremor hand within the same patients.ResultsSeven (21.2%) of the 33 patients had carpal tunnel syndrome. All of carpal tunnel syndrome patients showed neurophysiological abnormalities in both the hand without tremor and the hand with tremor. In addition, in patients without carpal tunnel syndrome, the sensory nerve action potential was lower in the hand without tremor than in the hand with tremor, although there were no significant differences.ConclusionsWe concluded that hand tremor in de novo Parkinson’s disease patients was not directly related to the development of carpal tunnel syndrome. In contrast, more frequent use of hand without tremor may induce mechanical loading and may be associated with CTS in the hand without tremor. Early diagnosis of Parkinson’s disease and proper education in hand use may be essential for preventing carpal tunnel syndrome in Parkinson’s disease tremor patients.

Highlights

Parkinson’s disease (PD), as a common movement disorder, has as its core cardinal features bradykinesia, rigidity, postural instability, and tremor
In patients without carpal tunnel syndrome, the sensory nerve action potential was lower in the hand without tremor than in the hand with tremor, there were no significant differences
Carpal tunnel syndrome (CTS) is the most commonly observed neuropathy in the general population, and it result from compression of the median nerve at the carpal tunnel level [2]

Summary

Introduction

Parkinson’s disease (PD), as a common movement disorder, has as its core cardinal features bradykinesia, rigidity, postural instability, and tremor. Carpal tunnel syndrome (CTS) is the most commonly observed neuropathy in the general population, and it result from compression of the median nerve at the carpal tunnel level [2] It affects approximately 4% of the population and can lead to substantial functional impairments of the hands as well as work disability [3]. To examine the hypothesis that repetitive mechanical movement may be related to the risk for CTS in PD, we performed neurophysiologic study in PD patients with unilateral hand tremor. Our objective in this study was to examine whether repetitive mechanical movement may be related to the development of carpal tunnel syndrome in Parkinson’s disease with unilateral hand tremor using neurophysiological methods.

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Discussion

Conclusion