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carpal tunnel syndrome

Acute and chronic neuropathies

Author/s: 
Ginsberg, L.

Peripheral nerve disorders are common and often treatable. The ‘default’ presentation of a polyneuropathy is a chronic, length- dependent, sensorimotor axonopathy. Recognizing deviations from this default, informed by the clinical features and investigations, can help identify the cause of a neuropathy in most cases. For inflamma- tory causes, such as GuillaineBarre syndrome and chronic inflamma- tory demyelinating polyradiculoneuropathy, there are effective immunomodulatory treatments. For other neuropathies, management consists of supportive care and treatment of the underlying cause, to prevent or limit progression.

Keywords 
carpal tunnel syndrome chronic inflammatory demyelinating polyradiculoneuropathy diabetes mellitus Guillaine-Barre syndrome mononeuropathy Charcote-Mariee-Tooth disease polyneuropathy vasculitis nerve biopsy multifocal motor neuropathy

Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline

Author/s: 
American Academy of Orthopaedic Surgery

Overview

This clinical practice guideline is based on a systematic review of published studies with regard to the diagnosis and treatment of carpal tunnel syndrome (CTS). In addition to providing practice recommendations, this guideline also highlights limitations in the literature and areas that require future research.

This guideline is intended to be used by all qualified and appropriately trained physicians and surgeons involved in the diagnosis and treatment of CTS. It is also intended to serve as an information resource for decision makers and developers of practice guidelines and recommendations.

The following definition of carpal tunnel syndrome has been added to the introduction section: “For the purpose of this guideline, Carpal Tunnel Syndrome (CTS) is defined as follows: Carpal Tunnel Syndrome is a symptomatic compression neuropathy of the median nerve at the level of the wrist, characterized physiologically by evidence of increased pressure within the carpal tunnel and decreased function of the nerve at that level. Carpal Tunnel Syndrome can be caused by many different diseases, conditions and events. It is characterized by patients as producing numbness, tingling, hand and arm pain and muscle dysfunction. The disorder is not restricted by age, gender, ethnicity, or occupation and is associated with or caused by systemic disease and local mechanical and disease factors.

Keywords 
carpal tunnel syndrome diagnosis compression neuropathy median nerve
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