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Dr. mahmoud wahdan :: Publications:

Title:
Structural and Functional Changes of the Median Nerve in Carpal Tunnel Syndrome
Authors: Mohamed M.Adawi , Mahmoud M. Wahdan , Ahmed Elnoury
Year: 2017
Keywords: carpal tunnel release , Neuro-physiolgical monitoring , Ultrasound
Journal: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Volume: Not Available
Issue: Not Available
Pages: Not Available
Publisher: Not Available
Local/International: Local
Paper Link: Not Available
Full paper mahmoud wahdan_Carpal Tunnel Syndrome.docx
Supplementary materials Not Available
Abstract:

Background : Chronic compression of a nerve usually results in a combination of focal demyelination and axon degeneration . These changes are responsible for abnormalities detected on electrophysiological evaluation . Ultrasound (U/S) can be used for diagnosis of peripheral nerve entrapment neuropathies, the entrapped nerve is typically presented with swelling proximal to the entrapment site. Objectives: This study aims to assess the neurophysiological and anatomical changes after surgical treatment of carpal tunnel syndrome by using ultrasonographic and nerve conduction studies, and try to find any correlation to diagnosis and clinical outcome of carpal tunnel syndrome. Patients & Methods: Thirty patients diagnosed with carpal tunnel syndrome were randomly chosen, ultrasonography and nerve conduction studies were done pre-operatively and repeated 3 months post-operatively. Results : Twenty patients (66.7%) with pre-operative ultrasound changes compatible with diagnosis of carpal tunnel syndrome improved post-operatively, while two patients (6.7%) with similar ultrasound changes didn’t improve post-operatively. Eight patients (26.7%) with normal pre-operative ultrasound readings remained unchanged. Twenty patients (66.7%) with affected nerve conduction velocity improved post-operatively, while six patients (20%) with affected nerve conduction velocity didn’t improve post-operatively. Four patients (13.3%) were found to have normal pre and post operative nerve conduction velocity measurements. Conclusion: Combination between the high resolution ultrasound and nerve conduction velocity increases the accuracy of diagnosis of carpal tunnel syndrome, and provides promising clues in determining outcome.

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