title: Is carpal tunnel syndrome present in acute stroke patients? An investigative study using clinical and imaging screening tools.
abstract: Carpal tunnel syndrome (CTS) is known to develop post-stroke. Median nerve ultrasound (US) is an inexpensive, effective means of screening. In this prospective feasibility study, we compared the ability of the physical exam, the Boston Carpal Tunnel Questionnaire (BCTQ) and median nerve US to screen for carpal tunnel syndrome (CTS) within 72hours of stroke onset. We enrolled 24 consecutive patients. Using US, 19 (79%, p=0.0386) of the 24 patients screened positive for CTS on the paretic side and 20 (83%, p=0.0042) on the nonparetic side. With clinical examination, only 11 out of 24 (46%) screened positive for CTS on the paretic side and 8 (33%) on the nonparetic side. The BCTQ did not predict CTS. US can be an effective screening tool post-stroke. Further research is needed to determine specificity and efficacy compared to electrodiagnostic testing in this population.
authors.affiliation: Department of Neurology, Duke University Hospital, Durham, NC, USA; Department of Neurology, Northwestern University Hospital, Chicago, IL, USA. Electronic address: chen.lin1@northwestern.edu.
authors.forename: Chen
authors.initials: C
authors.lastname: Lin
authors.affiliation: Department of Neurology, Duke University Hospital, Durham, NC, USA.
authors.forename: Aaron I
authors.initials: AI
authors.lastname: Loochtan
authors.affiliation: Department of Neurology, Duke University Hospital, Durham, NC, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Dresser
authors.affiliation: Department of Neurology, Duke University Hospital, Durham, NC, USA.
authors.forename: Jianhong
authors.initials: J
authors.lastname: Chang
authors.affiliation: Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Farjat
authors.affiliation: Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Kingshuk
authors.initials: K
authors.lastname: Choudhury
authors.affiliation: Department of Neurology, Duke University Hospital, Durham, NC, USA.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Hobson-Webb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000000981:diagnostic imaging / Q000209:etiology*; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods* / Q000592:standards
keywords: Carpal tunnel syndrome; Entrapment neuropathy; Median nerve; Stroke; Stroke complications; Stroke rehabilitation; Ultrasound