Sakhel J, Ahlhelm F, Schwerdtfeger K, Steudel W-I, Kelm J, Loew C, Nabhan A
Neurochirurgische Belegabteilung, Rotkreuzkrankenhauses Saarlouis.
Fortschr Neurol Psychiatr. 2002 Jan;70(1):46-51. doi: 10.1055/s-2002-19558.
Additionally to the typical carpal tunnel symptoms, the patients of this study had atypical complaints. Other reasons for these symptoms than those caused by the compression of the median nerve could be excluded using medical examination or imaging techniques. Purpose of this study was to investigate whether decompression of the median nerve may reduce or even abolish the atypical complaints.
For this prospective study 378 patients with carpal tunnel syndrome were clinically and electroneurographically examined, which was performed before and after (3 months) they underwent surgical decompression of the median nerve.
70 patients (19 % of all patients) with carpal tunnel symptoms suffered from additional atypical symptoms such as cardiac pain, ipsilateral headache as well as neck and shoulder pain. The diagnosis of carpal tunnel syndrome was made using clinical and electroneurographical examination. Carpal tunnel symptoms of all patients disappeared completely after surgery. Respectively, 61 % of those patients with preoperative atypical complaints did also fully recover.
This study shows that patients with carpal tunnel syndrome may also suffer from atypical complaints. These symptoms have been shown to be associated with the compression of the median nerve. They may be caused by spinal synaptic interaction between sensory and sympathetic/parasympathetic neuronal pathways by somatically-induced reflex responses.
除典型的腕管综合征症状外,本研究中的患者还有非典型主诉。通过医学检查或影像学技术可排除这些症状由正中神经受压以外的其他原因所致。本研究的目的是调查正中神经减压是否可以减轻甚至消除这些非典型主诉。
对于这项前瞻性研究,378例腕管综合征患者在接受正中神经手术减压之前和之后(3个月)进行了临床和神经电生理检查。
70例(占所有患者的19%)有腕管综合征症状的患者还伴有其他非典型症状,如心痛、同侧头痛以及颈部和肩部疼痛。通过临床和神经电生理检查做出腕管综合征的诊断。所有患者的腕管综合征症状在术后完全消失。术前有非典型主诉的患者中,分别有61%也完全康复。
本研究表明,腕管综合征患者可能还伴有非典型主诉。这些症状已被证明与正中神经受压有关。它们可能是由躯体诱导的反射反应,通过感觉神经与交感/副交感神经神经元通路之间的脊髓突触相互作用引起的。