title: Amelioration by mecobalamin of subclinical carpal tunnel syndrome involving unaffected limbs in stroke patients.
abstract: Our previous study showed that overuse of the nonparetic hand and wrist of the nonparetic side following stroke result in significantly more abnormal on the nonparetic side than on the hemiparetic side in terms of electrophysiologic indices of median nerve function. The purpose of this study was to evaluate the effects of the orally administered mecobalamin, an analogue of vitamin B12, for carpal tunnel syndrome (CTS) in the nonparetic side in patients following stroke. In a randomized open label and prospective study of stroke patients, 67 received of 1500 mug mecobalamin daily for 2 years, and the remaining 68 (untreated group) did not. At baseline, sensory nerve conduction velocity, motor nerve conduction velocity, sensory nerve action potentials (SNAP) at the wrist, palm-to-wrist distal sensory latency, palm-to-wrist SNAP, motor nerve conduction velocity compound motor action potentials, and distal motor latency of median nerve were significantly more abnormal on the nonparetic side than on the hemiparetic side or in controls. Before the treatment 21 patients (31%) of untreated and 20 patients (30%) of treated group met electrophysiologic criteria for CTS. Sensory impairment of the nonparetic side had lessened in the treated group. After 2 years, all electrophysiologic indices of nonparetic side were significantly improved in the treated group compared with those in the untreated group. The improvement from baseline of electrophysiologic parameters in sensory nerve in the treated group was greater than the improvement measured in motor nerve. There were no side effects. Oral mecobalamin treatment is a safe and potentially beneficial therapy for CTS in stroke patients.
authors.affiliation: Department of Neurology, Mitate Hospital, 3237 Yugeta, Tagawa 826-0041, Japan. y-sato@ktarn.or.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sato
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Honda
authors.forename: Jun
authors.initials: J
authors.lastname: Iwamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kanoko
authors.forename: Kei
authors.initials: K
authors.lastname: Satoh
mesh_terms: D000200:Action Potentials / Q000187:drug effects; D000284:Administration, Oral; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000188:drug therapy*; D004558:Electric Stimulation / Q000379:methods; D005121:Extremities / Q000294:innervation / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000187:drug effects*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000187:drug effects / Q000503:physiopathology; D009431:Neural Conduction / Q000187:drug effects; D011446:Prospective Studies; D011930:Reaction Time / Q000187:drug effects; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D014805:Vitamin B 12 / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D014953:Wrist / Q000294:innervation / Q000503:physiopathology
chemical_list: C019476:mecobalamin; D014805:Vitamin B 12