Abstract
Although many studies on carpal tunnel syndrome (CTS) have been reported, few data on the natural history of CTS are available. Knowledge of the natural course of the disease has significant clinical and therapeutic value. We prospectively followed up 80 cases of untreated CTS. The evaluation was based on self-administered questionnaires and on neurophysiological investigation. According to the neurophysiological classification, cases of CTS were divided into six groups on the basis of impairment severity: negative, minimal, mild, moderate, severe, and extreme. Disease worsening was inversely related to severity of nerve entrapment. On the contrary, improvement was proportionally related to nerve function impairment (except for extreme cases that never improved), and about one-third of mild and moderate cases improved. Most minimally cases remained neurophysiologically unchanged. We hypothesize that in a good percentage of CTS cases, nerve impairment is self-limited. Our data suggest the utility of further studies on the natural course of this common disease.
Sommario
Sebbene siano stati effettuati molti studi sulla sindrome del tunnel carpale (STC), in letteratura sono riportati pochi dati sulla storia naturale di tale patologia. La conoscenza dell'evoluzione naturale ha molte implicazioni cliniche e terapeutiche. Abbiamo eseguito prospetticamente il follow-up di 80 mani affette da STC non trattate. La valutazione è stata basata su un questionario auto -somministrato e sull'esame neurofisiologico. Le mani sono state divise secondo la classificazione neurofisiologica in STC negativa, minima, lieve, medio, grave, estrema.
Il peggioramento è apparso inversamente correlato al grado di sofferenza del nervo, al contrario il miglioramento è apparso proporzionale alla compromissione della funzione nervosa (ad eccezione dei casi estremi the non sono mai migliorati), circa un terzo dei casi lievi e medi sono migliorati. La maggior parte dei casi minimi sono rimasti neurofisiologicamente invariati. Le nostre osservazioni suggeriscono che in una buona percentuale dei casi affetti da STC avviene un'autolimitazione della sindrome. I nostri dati suggeriscono ulteriori studi sulla naturale evoluzione di questa comune patologia.
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Padua, L., Lo Monaco, M., Aprile, I. et al. Natural history of carpal tunnel syndrome according to the neurophysiological classification. Ital J Neuro Sci 19, 357–361 (1998). https://doi.org/10.1007/BF02341782
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DOI: https://doi.org/10.1007/BF02341782