View source for 7A. Carpal tunnel-syndrome

Carpal tunnel syndrome is the most common cause of median nerve lesion. It’s a compression neuropathy due to entrapment of the median nerve within the carpal tunnel at the wrist. Demyelination of the median nerve occurs.

The risk factors are:

* Obesity
* Female
* Diabetes
* Pregnancy
* Certain repetitive wrist movements at work

== Clinical features ==
Sensory symptoms are most common, but motor symptoms also occur. Sensory symptoms include numbness in the palm, palmar aspect of fingers 1 – 3 and the radial half of the 4 finger. Motor symptoms include dropping things they’re holding, weak pinching. A typical symptom is a need to shake the hand during the night because of numbness.

== Diagnosis and evaluation ==
ENG can show demyelination (slow conduction), and ultrasound can show enlarged nerve. Tinel sign can be positive and involves worsening symptoms when tapping the carpal tunnel.

== Treatment ==
Treatment options include splinting, steroid injection, and surgical decompression of the nerve by cutting of the carpal tunnel.
[[Category:Neurology 2]]