Girlanda P, Dattola R, Venuto C, Mangiapane R, Nicolosi C, Messina C
Institute of Neurological and Neurosurgical Sciences, University of Messina, Italy.
J Neurol. 1993;240(3):187-90. doi: 10.1007/BF00857526.
A clinical and electrophysiological study evaluated the usefulness of local steroid therapy for carpal tunnel syndrome (CTS). To evaluate the efficacy of local steroid therapy 32 patients (53 nerves) were randomly assigned to one of two groups: one (27 nerves) received 15 mg methylprednisolone acetate injected locally and the other (26 nerves) received the same amount of saline solution. The injections were repeated after a week. Clinical and electrophysiological findings were evaluated, double blind, at regular intervals. A clear-cut efficacy of steroid treatment was found. Only 8% of nerves were not benefitted while a marked early improvement was observed in most of the nerves. In order to appraise the long-term effect of local steroid treatment on CTS, 53 patients (91 nerves) were studied and followed up by means of clinical and electrophysiological examinations performed every 2 months for 2 years. The benefit of steroid treatment was transient. About 50% of the nerves became worse within 6 months and 90% within 18 months. Only a small percentage (8%) of the nerves remained improved at the 2-years follow-up. The clinical features were not useful in foretelling the duration of the improvement, which appeared to be related to the antidromic SAP latency.
一项临床和电生理研究评估了局部类固醇疗法对腕管综合征（CTS）的有效性。为评估局部类固醇疗法的疗效，32例患者（53条神经）被随机分为两组：一组（27条神经）接受局部注射15mg醋酸甲泼尼龙，另一组（26条神经）接受等量的生理盐水。一周后重复注射。定期对临床和电生理结果进行双盲评估。发现类固醇治疗有明确疗效。只有8%的神经未受益，而大多数神经出现明显的早期改善。为评估局部类固醇治疗对CTS的长期效果，对53例患者（91条神经）进行了研究，并通过每2个月进行一次临床和电生理检查，持续2年进行随访。类固醇治疗的益处是短暂的。约50%的神经在6个月内恶化，90%在18个月内恶化。在2年随访时，只有一小部分（8%）神经仍保持改善。临床特征无法预测改善的持续时间，改善似乎与逆向感觉动作电位潜伏期有关。
