Clinical and electromyographic evidence of carpal tunnel syndrome in a hypertensive patient with chronic beta-blocker treatment

Historical review of carpal tunnel syndrome

The first description of median nerve compression in the carpal tunnel goes back to 1854, but it was only a century later that the term "carpal tunnel syndrome" (CTS) appeared in print. Until then, patients with symptoms, which we now know were due to CTS, were sometimes diagnosed as having acroparaesthesia, and at other times compression of the motor branch of the median nerve or the brachial plexus. The first description of an operation to open the carpal tunnel goes back to 1933, but only with Brain and Phalen was idiopathic CTS defined from both clinical and anatomopathological viewpoints. Since 1960, CTS has become the most frequently diagnosed of peripheral compression-induced neuropathies. The last part of this paper reports the latest theories giving an aetiological explanation of cases of CTS until now considered to be idiopathic.

Upper extremity mononeuropathy among engineers

OBJECTIVES

The objectives of this study were to estimate the prevalence of mononeuropathy at the wrist among engineers who use computers and to identify associated risk factors.

METHODS

This is a cross-sectional study of 202 engineers using questionnaires and electrophysiological nerve testing. The definition for median or ulnar mononeuropathy required the combination of distal upper extremity discomfort and abnormal distal motor latency.

RESULTS

The prevalence of neuropathy at the wrist among engineers was 10.3% (right median), 3.4% (left median), 1.8% (right ulnar), and 2.9% (left ulnar). Logistic regression analysis identified three variables with positive associations (body mass index, hours of computer use, and antihypertensive medication) and three variables with negative associations (typing speed, driving hours, total break time).

CONCLUSIONS

Mononeuropathies at the wrist occur among computer-using engineers and are related to a number of factors, including hours of computer use.