title: Carpal tunnel syndrome in the elderly. "Beware of severe cases".
abstract: This study compares the clinical and electrophysiological features of Carpal Tunnel Syndrome (CTS) in elderly (over 70 years of age) and middle age populations (50-60 years of age). Our study shows a severe (95%) electrophysiological motor and sensory denervation of CTS, in 60% of the elderly group and only 18% of the middle aged group (P much much less than 10(-3). Clinically, the presence of thenar wasting was the only reliable sign of significant denervation, Phalen's test, Tinel sign and painful paresthesia being equivocal. Some 18% of the elderly were asymptomatic despite 25% of these patients having severe neurological impairment. It was noted that exclusively diurnal paresthesiae were confined to the elderly group (23%) (P much less than 10(-3)). To avoid permanent disability the elderly should be viewed as a high risk group of severe cases even in the absence of firm clinical evidence and should undergo objective electrophysiological assessment with a view to surgical intervention as a priority.
authors.forename: P
authors.initials: P
authors.lastname: Seror
mesh_terms: D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D002940:Circadian Rhythm; D004576:Electromyography; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010292:Paresthesia / Q000209:etiology / Q000503:physiopathology; D012720:Severity of Illness Index