title: Long-term outcomes of symptomatic electrodiagnosed carpal tunnel syndrome.
abstract: This study was done to evaluate the long-term patient's satisfaction after carpal tunnel syndrome (CTS) electrodiagnostic done between 1989 and 1994 (5 to 10 years follow-up). Mail contact was made to 528 consecutive cases with a questionnaire to be filled; 165 patients responded after 19 exclusions. CTS severity was graded from 0 (incipient) to 4 (severe) after a combination of median sensory distal latency, sensory median-radial latency difference and amplitude of the median compound muscle action potential. Current symptoms ("cure", improved, unchanged or worsed) and the therapy utilized, either surgical or conservative, were analyzed to the initial CTS severity, age and duration of symptomatology. Surgical release was done in 114 cases (69%). Patient's satisfaction after surgical and non-surgical were respectively, 77.6% and 16% ("cure"), 13.6% and 52% (much improved), 5.4% and 9.3% (little improved), 2.7% and 16% (unchanged), 0.7% and 6.7% (worsed). The frequency of "cure" versus unchanged/worsed or "cure"/much improved versus unchanged/worsed was highly significative (Fisher, P-value < 0.001) and was not influenced by the CTS electrophysiological severity. There was no relationship between the outcome after surgery and duration of symptomatology, age or CTS severity. Conservative benefice was more prevalent in those with shorter symptomatology and older age; the majority of conservative failure cases had mild initial CTS. We concluded the excellent surgical benefice described by patients and the absence of any predictive factors based on CTS severity, age or duration of symptomatology for outcome.
authors.affiliation: Electromyography Laboratory, Clinical Neurophysiology, Department of Neurological Sciences, State Medical School, São Jose do Rio Preto, SP, Brazil. jaris@terra.com.br
authors.forename: Joao Aris
authors.initials: JA
authors.lastname: Kouyoumdjian
authors.forename: Maria P A
authors.initials: MP
authors.lastname: Morita
authors.forename: Amalia F P
authors.initials: AF
authors.lastname: Molina
authors.forename: Dirce M T
authors.initials: DM
authors.lastname: Zanetta
authors.forename: Adriana K
authors.initials: AK
authors.lastname: Sato
authors.forename: Carlos E D
authors.initials: CE
authors.lastname: Rocha
authors.forename: Claudia C
authors.initials: CC
authors.lastname: Fasanella
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004558:Electric Stimulation; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome