The carpal tunnel syndrome. Diagnosis and treatment

The carpal tunnel syndrome is the most frequent cause of acroparesthesias of the upper limb. It affects women in 80% of the cases. Classically its diagnosis rests on clinical data; sensory manifestations, more marked at night, are seen earlier than motor manifestations which appear later. In the relatively frequent cases where the topography of the pain is atypical, electromyography represents a determining diagnostic factor. The treatment, initially, is based on steroids infiltrations within the tunnel, representing a true diagnostic test. In case of failure of the medical treatment, especially when there are signs of motor denervation, the surgical decompression of the median nerve is mandatory, with division of the anterior carpal ligament and possibly completed by a careful neurolysis.