Gupta S K, Benstead T J
Division of Neurology, Dalhousie University, Halifax, Nova Scotia, Canada.
Can J Neurol Sci. 1997 Nov;24(4):338-42. doi: 10.1017/s0317167100033023.
Patients with carpal tunnel syndrome (CTS) sometimes report sensory symptoms outside the median nerve distribution. This study was designed to provide a more detailed assessment of these symptoms.
Patients with clinical suspicion of upper limb neuromuscular lesions were divided into those with electrodiagnostic (EDX) evidence of CTS, and those without. CTS patients with superimposed nerve abnormalities were excluded. Motor and sensory symptoms were assessed in the exclusive CTS patients.
Over 50% of patients with exclusive CTS reported tingling or numbness over the whole hand, ulnar or radial nerve distributions. Some patients reported symptoms proximal to the wrist. Sensory signs did not extend beyond the median nerve distribution. Numbness and nocturnal pain were predictive of positive EDX evidence of CTS.
Sensory symptoms outside the distribution of the median nerve are common in CTS. For enhanced sensitivity in diagnosis it is useful to be aware of these "atypical" symptoms. Reports of numbness and nocturnal pain are strong indicators of CTS.
腕管综合征（CTS）患者有时会报告正中神经分布区域以外的感觉症状。本研究旨在对这些症状进行更详细的评估。
临床怀疑有上肢神经肌肉病变的患者被分为有CTS电诊断（EDX）证据的患者和无该证据的患者。排除合并有神经异常的CTS患者。对单纯CTS患者的运动和感觉症状进行评估。
超过50%的单纯CTS患者报告整个手部、尺神经或桡神经分布区域有刺痛或麻木感。一些患者报告手腕近端有症状。感觉体征未超出正中神经分布范围。麻木和夜间疼痛可预测CTS的EDX阳性证据。
正中神经分布区域以外的感觉症状在CTS中很常见。为提高诊断的敏感性，了解这些“非典型”症状很有用。麻木和夜间疼痛的报告是CTS的有力指标。
