Syed Muhammad Anwar Shah, Qazi Ikramullah, Akhtar Sherin.
Carpal tunnel syndrome: clinical and electrodiagnostic study features.
J Postgrad Med Inst Jan ;19(4):420-4.

Objective: To identify the clinical and electrodiagnostic study (EDS) features of carpal tunnel syndrome (CTS). Material and Methods: This study was conducted in out-patients of the department of Medicine, Lady Reading Hospital, Peshawar from 15th April to 20th July, 2005. A detailed history was followed by physical examination. EDS was performed according to the American Association of Electrodiagnostic Medicine criteria in private sector. Results: Fifty confirmed patients of CTS were included in the study: The CTS was more common in females. The most common symptom was episodic pain/paresthesias localized to wrist or hand in 45 (90%) patients. Phalen`s maneuver reproduced symptoms in 40 (80%) cases. There was weakness of thumb abduction and opposition in 38 (76%) and wasting of thenar eminence in 32 (64%) cases. On EDS, CTS was mild in 14 (28%), moderate in 21 cases (42%) and severe in 15 cases (30%). Both clinical and EDS showed that 39 (78%) patients had bilateral CTS. Two (4%) patients had mild symptoms but clear signs of CTS and EDS suggested severe CTS. Only one (2%) patient had severe symptoms but mild CTS on EDS. Conclusion: The CTS is one of the characteristic nerve entrapment syndromes more common in females. Episodic pain/paresthesia localized to wrists, weakness of thumb abduction and opposition; wasting of thenar eminence and positive Phalen`s maneuver are important clinical parameters. The EDS can grade CTS into grades of severity and excluding other diagnoses mimicking it.

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