Carpal Tunnel Syndrome: A Clinical and Electrophysiological Appraisal in Carpal Tunnel Syndrome

Background: Indian studies, especially from this part (NCR Region) are scarce in Carpal tunnel syndrome (CTS), the most common entrapment neuropathy. Aim of this study was to analyze clinical and electrophysiological profile in CTS. Materials and Methods: 50 hands (35 patients) with clinical features compatible with CTS were included in the study. Detailed clinical, laboratory and electrophysiological evaluations of patients were done. The patients were followed up to a period of one year. Results: The mean age of patients was 43.5 years with M: F ratio of 15: 38. Symptoms were bilateral in 30% of patients. The most common symptom was numbness sensation in hands, followed by pain while least common was colour change .Sensory loss was observed in 60% while clumsiness was noted in 40% of hands. Thyroid abnormalities were associated with 30% of hands. Mean EPS Grade was 3.32, with the most common electrophysiological abnormality was increase in latency difference between median and ulnar sensory nerves. This was also seen as the only electrophysiological abnormality in 8%. The least common abnormality was un-recordable CMAP. The patients with only a change in the sensory latency responded well to drugs and use of splint. Those who had in addition abnormal CMAP did not respond so well. The patients with thenar atrophy also did not respond well. Conclusion: Carpal tunnel syndrome commonly presents with numbness in both hands with frequently associated hypothyroidism. Electrophysiological abnormalities can help in predicting the therapeutic response and prognosis. Abnormalities of CMAP and presence of atrophy are predictors of poor prognosis.