Predlog priporočil za obravnavo bolnikov s sindromom zapestnega prehoda v Sloveniji
Proposal for Slovenian recommendations for the treatment of patients with carpal tunnel syndrome

slovenian

2008

volume 77, issue 2

Carpal Tunnel Syndrome   Diagnosis   Median Nerve   Neural Conduction   Practice Guidelines   Therapy

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Entrapment neuropathy of the median nerve in the carpal tunnel (NMCT) is the most common lesion of the peripheral nervous system. Clinically it presents asnight-time or morning numbness and tingling in at least two out of the, first four digits (i. e. carpal tunnel syndrome - CTS). Due to a large number of such patients we suggest general practitioners to refer all patients with typical and pronounced CTS symptoms directly to the nerve conduction studies. Referred patients should not refuse surgical release and their symptoms shouldlast at least 6 months. In patients with normal neurophysiologic findings clinical follow-up, and in case of severe symptoms application o f splints during the night is recommended. Those with pathologic neurophysiologic ,findings should be referred to surgeons. Inpatients with typicalfindings in whom NMCT was previousl_y confirmed neurophysiologically wedo not recommend repeated measurements. In the paper we present our suggestions, for management of patients with CTS. Nerve conduction studies areproposed only in patients with severe symptoms o f long duration, who agreewith surgical release of the median nerve. In patients with neurophysiologically confirmed NMCT relatively early surgical release is suggested. Besides providing a practical help to physicians in their practice these recommendations are also aimed to constitute the base for further discussions and official recommendations for Slovenia.

16.09.2009