carpaltunnel syndrome

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• Carpal Tunnel Syndrome
o This is a syndrome
characterised by the
compression of the median
nerve as it passes beneath the
flexor retinaculum (MCQ)
• Causes of carpal tunnel
syndrome
o Idiopathic (Most common)
(MCQ)
o Obesity
o oral contraceptives (MCQ)
o hypothyroidism (MCQ)

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o arthritis
o diabetes, prediabetes (impaired
glucose tolerance) (MCQ)
o trauma.
o Charcot-Marie-Tooth syndrome
type 1 called hereditary
neuropathy with liability to
pressure palsies.
o extrinsic factors where pressure
is exerted from outside the tunnel
as lipomas, ganglion, and
vascular malformation.
o transthyretin amyloidosis-
associated polyneuropathy

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• Clinical features
o Classical Clinical Vignette in PG Medical
Entrance (MCQ)
n The patient is generally a middle aged
woman complaining of tingling, numbness or
discomfort in the thumb and radial one and a
half fingers i.e., in the median nerve
distribution.

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o Tingling is more prominent during sleep.
(MCQ)
o There is a feeling of clumsiness in carrying
out fine movements.
•

5. Nerve conduction studies show delayed or
absent conduction of impulses in the
median nerve across the wrist.
• Treatment is by dividing the flexor
retinaculum, and thus decompressing
the nerve. (MCQ)
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