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Nerve ultrasound in clinical management of carpal tunnel syndrome in mucopolysaccharidosis
Author(s) -
Bäumer Tobias,
Bühring Nina,
Schelle Thomas,
Münchau Alexander,
Muschol Nicole
Publication year - 2016
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13127
Subject(s) - carpal tunnel syndrome , medicine , ultrasound , wrist , median nerve , forearm , compound muscle action potential , electrophysiology , echogenicity , mucopolysaccharidosis , sensory nerve , carpal tunnel , surgery , anesthesia , sensory system , radiology , psychology , cognitive psychology
Aim Mucopolysaccharidoses ( MPS ) are a group of diseases with an almost 100% lifetime incidence of carpal tunnel syndrome ( CTS ) in MPS subtypes I, II , and VI . We compared nerve ultrasound with clinical signs and electrophysiology in a clinical setting to screen for CTS in MPS . Method Twenty‐four patients (13 male, 11 female, mean age of 7y 11mo [ SD 8y 5mo], range 6mo–29y) were screened for CTS . Eight of these patients were re‐examined post‐operatively. Clinical signs, distal motor latency, compound muscle action potential, sensory nerve action potential amplitude and velocity, as well as echogenicity and the cross‐sectional area ( CSA ) of the median nerve at the wrist and forearm determined with ultrasound were assessed and the wrist to forearm ratio ( WFR ) calculated. Eighteen healthy participants formed a comparison group, who were also investigated with nerve ultrasound. Results In 26% of the patients' hands, clinical signs of CTS were present; 77% fulfilled electrophysiological and 92% nerve ultrasound criteria for CTS . Post‐operatively, electrophysiology improved significantly, whereas ultrasound results were unchanged. In the comparison group, age and height correlated with the CSA , but not with WFR . Interpretation Nerve ultrasound is a useful and painless primary screening tool for CTS in MPS .