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FARKLI DÜZEY KARPAL TÜNEL SENDROMLU HASTALARDA SEMPATİK DİSFONKSİYON

SYMPATHETIC DYSFUNCTION IN PATIENTS WITH DIFFERENT SEVERITY OF CARPALTUNNELSYNDROME

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2009

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: Carpal tunnel syndrome (CTS) is an entrapment mononeuropathy of the median nerve at the wrist. Recently, it was reported that in the entrapment neuropathies, which involved motor and sensorial fibers, autonomic impression might occur. The aim of this study was to investigate the relationship between electrophysiological severity of CTS and sympathetic dysfunction, using the sympathetic skin response (SSR). Material and methods: Fifty patients with CTS and 34 healthy subjects were enrolled to the study. Patients were divided into mild or severe CTS groups in terms of electrophysiological findings. SSR values were measured in all subjects who enrolled in the study. Results: All motor and sensory nerve conduction parameters were affected in severe CTS; there were statistically significant differences than the controls (p<0.01). SSR latency in severe CTS group was more delayed than mild CTS and controls (F=6.1, p<0.005). SSR latency were correlated with median nerve peak distal sensory latency, the difference between median and ulnar nerves’ peak distal sensory latencies and median nerve distal motor latency in severe CTS group (p<0.000, p<0.000, p<0.005, respectively). Conclusion: These results suggested that there was sympathetic fibers’ involvement beside motor and sensory fibres in CTS and sympathetic involvement became clear when the entrapment was increased.
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Abstract (Original Language): 
Amaç: Karpal tünel sendromu (KTS) median sinirin el bile¤i seviyesindeki tuzaklanma mononöropatisidir. Son dönemde motor ve duysal sinir liflerini etkileyen çeflitli tuzak nöropatilerinde otonomik tutulumun da olabilece¤i belirtilmektedir. Bu çal›flman›n amac›, KTS’li hastalarda elektrofizyolojik aç›dan tutulum fliddeti ile sempatik disfonksiyon aras›ndaki iliflkinin sempatik deri yan›tlar› (SDY) kullan›larak araflt›r›lmas›d›r. Gereç ve yöntem: Klinik KTS tan›s› konan 50 hasta ile 34 sa¤l›kl› kifli çal›flmaya dahil edildi. KTS hastalar›, elektrofizyolojik de¤erlere göre hafif ve a¤›r KTS olarak iki gruba ayr›ld›. Çal›flmaya al›nan tüm olgular›n SDY’lerine bak›ld›. Bulgular: A¤›r düzeyde etkilenmifl gruptaki bütün motor ve duyusal sinir ileti de¤erlerinde etkilenme olup, kontrol grubuna göre istatistiksel olarak anlaml› farklar vard› (p<0,01). SDY latans› a¤›r etkilenmifl grupta, hafif etkilenmifl ve kontrol grubuna göre daha uzundu (F=6,1, p<0,005). SDY latans›, a¤›r KTS grubunda, median sinir tepe distal duyusal latans, median ve ulnar sinir tepe distal duyusal latans fark› ve median sinir distal motor latanslar› ile korele idi (s›ras›yla, p<0,000, p<0,000, p<0,005). Sonuç: Bu bulgular KTS’li hastalarda median motor ve duyusal liflerin tutulumununa sempatik lif tutulumun da efllik etti¤ini ve sempatik tutulumun tuzaklanma düzeyi artt›kça belirginleflti¤ini göstermektedir
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  • English

REFERENCES

References: 

1- Akelman E, Weiss APC. Carpal tunnel syndrome. Etiology and
endoscopic treatment. Orthop Clin North Am 1995; 26:769-778.
2- Argyriou AA, Polychronopoulos P, Moutopulou E, Aplada M,
Chroni E. The significance of intact sympathetic skin responses
in carpal tunnel syndrome. European Journal of Neurology 2006;
13: 455–459.
3- Arunodaya GR, Taly AB. Sympathetic skin response: a decade
Karpal Tünel Sendromunda Sempatik Disfonksiyon
‹stanbul T›p Fakültesi Dergisi Cilt / Volume: 72 • Say› / Number: 1 • Y›l/Year: 2009
- 17 -
Figure 2. Normative values for SSR and median nerve
latency in CTS
later. J Neurol Sci 1995; 129:81–89.
4- Baba M, Watahiki Y, Matsunaga M, Takebe K. Sympathetic skin
response in healthy man. Electromyogr Clin Neurophysiol 1988;
28: 277–283.
5- Braune HJ, Horter C. Sympathetic skin response in diabetic neuropathy:
a prospective clinical and neurophysiological trial on
100 patients. J Neurol Sci 1996;138:120–124.
6- Caccia MR, Galimberti V, Valla PL, et al. Peripheral autonomic
involvement in carpal tunnel syndrome. Acta Neurol Scand 1993;
88: 47-50.
7- Drory VE, Nisipeanu PF, Korczyn, AD. Tests of autonomic
dysfunction in patients with multiple sclerosis. Acta Neurol
Scand 1995; 92: 356–360.
8- Gutrecht JA. Sympathetic skin response. J Clin Neurophysiol
1994; 11:519–524.
9- Hoeldtke RD, Davis KM, Hshieh PB, Gaspar SR, Dworkin GE.
Autonomic surface potential analysis: assessment of reproducibility
and sensitivity. Muscle Nerve 1992;15: 926–931.
10- Jablecki CK. Literature review of the usefulness of nerve conduction
studies and electromyography for the evaluation of patients
with carpal tunnel syndrome. Muscle & Nerve 1993;16: 1392-
1414.
11- Kanzato N, Komine Y, Kanaya F, Fukiyama K. Preserved
sympathetic skin response at the distal phalanx in patients with
carpal tunnel syndrome. Clin Neurophysiol 2000; 111: 2057-
2063.
12- Kiylioglu N, Akyol A, Guney E, Bicerol B, Ozkul A, Erturk A.
Sympathetic skin response in idiopathic and diabetic carpal tunnel
syndrome. Clinical Neurology and Neurosurgery 2005; 108:
1–7.
13- Leventoglu A, Kuruoglu R. Karpal tünel sendromunun klinik
fliddetiyle elektrofizyolojik bulgular de¤ifliyor mu? Journal of Neurological
Sciences 2006; 23: 272-278.
14- Levy M, Reid G, Rowley DA. Quantitative measures of sympathetic
skin response in diabetes: relation to sudomotor and neurological
function. J Neurol Neurosurg Psychiatry 1992;55:
902–908.
15- Oytun Bayrak A, Erdem Tilki H, Coskun M. Sympathetic skin
response and axon count in carpal tunnel syndrome. J Clin Neurophysiol
2007; 24: 70–75
16- Phalen GS. The carpal-tunnel syndrome; seventeen years experience
in diagnosis and treatment of six hundred fifty-four hands. J
Bone Joint Surg 1966; 48:211-228.
17- Reddeppa S, Bulusu K, Chand PR, Jacob PC, Kalappurakkal J,
Tharakan J. The sympathetic skin response in carpal tunnel
syndrome. Autonomic Neuroscience: Basic &Clinical
2000;84:119-121.
18- Schondorf R. The role of the sympathetic skin response in the assessment
of autonomic function. In: Low PA(ed). Clinical Autonomic
Disorders: evaluation and management. Little Brown,
Boston, USA, 1993; pp 231-241.
19- fiener HÖ, Taflç›lar NF, Balaban H, Selçuki D. Sympathetic skin
response in carpal tunnel syndrome. J Clin Neurophysiol 2000;
111: 1395-1399.
20- Shahani BT, Day TJ, Cross D. R–R Interval variation and the
sympathetic skin response in assessment of autonomic function
in peripheral neuropathy. Arch Neurol 1990;47:659–664.
21- Shahani BT, Halperin, JJ, Bulu PJ, Cohen J. Sympathetic skin response
- a method of assessing unmyelinated axon dysfunction in
peripheral neuropathies. J Neurol Neurosurg Psychiat 1984; 47:
536–542.
22- Soliven B, Maselli R, Jaspan J. Sympathetic skin response in diabetic
neuropathy. Muscle & Nerve 1987; 10: 711-706.
23- Taly AB, Arunodaya, GR, Rao S. Sympathetic skin response in
Guillian Barre Syndrome. Clin Auton Res 1995; 5: 215–219.
24- Verghese J, Galanopoulou AS, Herskovitz S. Autonomic dysfunction
in idiopathic carpal tunnel syndrome. Muscle & Nerve
2000;23: 1209-1213.
25- Watahiki Y, Baba M, Matsunga M, Takebe K, Onuma T. Sympathetic
skin response in diabetic neuropathy. Electromyogr Clin
Neurophysiol 1989; 29:155–157.
26- Yokota T, Hayashi M, Tanabe H, Tsukagoshi H. Sympathetic skin
response in patients with cerebellar degeneration. Arch Neurol
1993; 50: 422–427.
27- Zgur T, Vodusek DB, Krzan M, Vrtovec M, Denislic M, Sibanc
B. Autonomic system dysfunction in moderate diabetic polyneuropathy
assessed by sympathetic skin response and Valsalva index.
Electromyogr Clin Neurophysiol 1993;33: 433-439.
28- Zyluk A, Kosowiec L. Regional sympathetic disturbances in carpal
tunnel syndrome-a review. Chir Narzadow Ruchu Ortop Pol.
2008; 73:30-36.
Suppliers
a. Esaote biomedica phasis II operator manual, release software
4.00, Evoked potentials section, Esoate biomedica, Florance,
1994.
b. Version 10, SPSS Inc., Chicago, IL Software-package.

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