Abstract
BackgroundThe association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment is unclear, and the extra-median paresthesia in the ulnar nerve territory innervation in CTS is unexplained. Our purpose is to evaluate the neurophysiologic changes in ulnar nerve sensory fibers secondary to idiopathic CTS in comparison to normal subjects, and their relation to the severity of CTS.ResultsThe difference between CTS and control hands regarding all parameters of ulnar motor nerve conduction studies (MNCS) was not statistically significant (p > 0.05). There was a statistically significant difference in all parameters of median sensory conduction study (SCS) and MNCS between CTS and control hands (p < 0.0001) except for conduction velocity and in all parameters of median and ulnar SCS recording digit 4 (D4) (p < 0.05). The mean value of abnormalities of ulnar SCS recording D4 and digit 5 (D5) was significantly higher in moderate and severe CTS hands (p < 0.05). There were significant negative correlations between median motor and sensory latency and ulnar sensory amplitude recording D4 and D5.ConclusionUlnar sensory nerve abnormalities exist among CTS patients, which were more in moderate and severe grades. The drop in amplitude of ulnar nerve sensory response argues in favor of the possible impact of CTS on the ulnar nerve and did not indicate axonal deterioration of the ulnar nerve.
Highlights
The association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment is unclear, and the extra-median paresthesia in the ulnar nerve territory innervation in CTS is unexplained
Increased pressure in the CTS causes a mechanical traction on the transverse carpal ligament increasing Guyon’s canal (GC) pressure resulting in functional changes in the ulnar nerve, and decompression surgery for CTS resulted in the relief of the GC pressure with spontaneous reduction in the symptoms regarding the ulnar nerve [6, 14,15,16,17]
The current study included 183 idiopathic CTS clinically diagnosed that were collected from 100 patients [89 women (89%) and 11 men (11%)]
Summary
The association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment is unclear, and the extra-median paresthesia in the ulnar nerve territory innervation in CTS is unexplained. Our purpose is to evaluate the neurophysiologic changes in ulnar nerve sensory fibers secondary to idiopathic CTS in comparison to normal subjects, and their relation to the severity of CTS. Increased pressure in the CTS causes a mechanical traction on the transverse carpal ligament increasing GC pressure resulting in functional changes in the ulnar nerve, and decompression surgery for CTS resulted in the relief of the GC pressure with spontaneous reduction in the symptoms regarding the ulnar nerve [6, 14,15,16,17].
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