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KMID : 0860920200220010042
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2020 Volume.22 No. 1 p.42 ~ p.46
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Atypical Carpal Tunnel Syndromes Related to Selective Fascicular Involvement of the Median Nerve and Concurrent Recurrent Median Motor Neuropathy
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Lee Hae-In
Kwon Soon-Woo
Lee Ah-Ry
Kwon Hee-Kyu
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Abstract
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Carpal tunnel syndrome (CTS) being the most common entrapment neuropathy makes physicians to easily overlook CTS variants. Here we report two cases of atypical carpal tunnel syndromes which were correctly diagnosed with precise electrodiagnostic findings. One patient seemed moderate to severe degree of CTS at first, but careful electrodiagnostic analysis proved predominant involvement of fascicles of motor nerve and sensory fibers to the thumb, which are located in the radial side of the median nerve. Sonographic findings and MRI demonstrated a mass arising from the median nerve compressing the radial side of the nerve at the wrist. Another patient at a glimpse seemed as mild degree of CTS, but deliberate analysis of electrodiagnostic findings showed separate severe neuropathy of recurrent motor branch of the median nerve. Surgical findings proved these findings and the patient received appropriate surgical treatment, leading to complete resolution of symptoms. Precise analysis of electrodiagnostic findings helped physicians to correctly diagnose these atypical CTS and lead to proper management.
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KEYWORD
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Carpal tunnel syndrome, Electrodiagnosis, Median nerve
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