Abstract:

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. The median nevre iscompressed within the carpal tunnel at the wrist. This compression result in disrupt of the blood-nervebarrier causing edema, inflamation and fibrosis of surrounding connective tissue. The next stage is adistruption of the myelin coverage of the nerve followed by damage to the axons. Most carpal tunnelsyndromes are idiopathic. Other causes include systemic disorders, local factors andoveruse/exertional factors. History, physical examination and electroneuromyography are essential forthe diagnosis. Patients usually suffer from numbness, tingling and pain on palmar side in radial 3.5fingers. Tipically patients are awakened at night by a numb hand. The physical examination may showhypesthesia in median nerve sensory distrubition, positive provocative tests and a weakness andatrophy of the thenar muscles. The typical finding in the nevre conduction velocity is a prolongedlatency period. The conservative treatment for CTS include rest, non-steroidal anti-inflamatory drugs,neutral position splints, and steroid injection. The indications for surgical treatment are failure ofconservative management or severe CTS. CTS is very important because of entrapment of themedian nevre at the wrist is the most frequent focal neuropathy in humans and a common cause ofpain in the forearm, particularly in women.

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