Síndrome do túnel do carpo: aspectos clínico-epidemiológicos e de condução nervosa em 668 casos

• Ano de defesa: 1998
• Autor(a) principal: Kouyoumdjian, João Aris
• Orientador(a): Chueire, Alceu Gomes
• Banca de defesa: Yacubian, Elza Márcia Targas , Brasil Neto, Joaquim Pereira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Faculdade de Medicina de São José do Rio Preto
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências da Saúde::123123::600
• Departamento: Medicina Interna; Medicina e Ciências Correlatas::123123::600
• País: BR
• Palavras-chave em Português: Neurologia; Síndrome do Túnel Carpal; Síndromes de Compressão Nervosa; Compressão Nervosa
• Palavras-chave em Inglês: Neurology; Carpal Tunel Síndrome; Nerve Crush
• Palavras-chave em Espanhol: Síndrome Del Túnel Carpiano; Compresión Nervosa
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::NEUROLOGIA::123123::600
• Link de acesso: http://bdtd.famerp.br/handle/tede/10

Carpal tunnel syndrome: clinical, epidemiological and nerve conduction studies in 668 cases Between January/89 and June/96, 1,059 carpal tunnel syndrome hands (CTS) from 668 patients were studied. None had been previously operated and all had bilateral conduction studies; peripheral neuropathy was excluded. The patients were selected with sensory median/radial difference (MRD) ³ 1.0 ms that strongly supports electrodiagnosis of CTS (standard deviation > 6) after simultaneous stimulation on wrist and recording on thumb. The age ranged from 17 to 83 years (mean 47.5) and 91.3% were female; the complaints were bilateral in 72% and nocturnal/awakening in 85.3%; pain, numbness and paraesthesia occurred in 64.4%; pain as the only symptom was rare but proximal extension was frequent (39.4%); all fingers were symptomatic in 42.5%, followed by middle, middle-ring, thumbindex- middle and then index-middle-ring ones; there was no correlation with traumatic past history on wrist. The duration CTS symptoms ranged from 1 to > 120 months without precise correlation with the severity of conduction abnormalities on median nerve. MRD ³ 1.0 ms correlates in 95% with median distal motor latency > 4.25 ms (80 mm distance) and with median distal sensory latency to index finger ³ 3.01 ms, middle finger ³ 3.14 ms and ring finger ³ 3.26 ms, all of them 140 mm distance, antidromic and onset-measured. The results have brought new values for the limit of normality in our EMG laboratory since MRD ³ 1.0 ms is very sensitive for CTS diagnosis.