Carpal tunnel syndrome in the nonparetic hands of hemiplegics. Stress-induced by ambulatory assistive devices.
Three patients who had earlier sustained an acute stroke were admitted to a rehabilitation bed service. Clinically, they developed symptoms suggestive of carpal tunnel syndrome (CTS) in their nonparetic hands during a progressive ambulation training program which included ambulatory assistive devices. In each patient, the diagnosis was confirmed by electrodiagnostic evaluation. Two of the three patients were subsequently provided with forearm platform attachments for their assistive devices, and cock-up wrist splints, in an attempt to decrease compression of the median nerve. Despite these measures, both remained symptomatic and had electrodiagnostic evidence of progressive CTS. They were referred for surgical decompression of the median nerve. The third patient had resolution of symptoms when she became able to ambulate without need of an assistive device. These cases are examples of CTS secondary to excessive pressure in the nonparetic hands of hemiparetic patients, believed to occur more frequently than is clinically recognized.
Kellner
W S
WS
Department of Rehabilitation Medicine, Sinai Hospital of Baltimore, Maryland 21215.
Felsenthal
G
G
Anderson
J M
JM
Hilton
E B
EB
Mondell
D L
DL
D000368:Aged; D002183:Canes / Q000009:adverse effects*; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004576:Electromyography; D005260:Female; D006429:Hemiplegia / Q000150:complications*; D006801:Humans; D009431:Neural Conduction; D009983:Orthopedic Equipment / Q000009:adverse effects*