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Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
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Vasculitis presenting as carpal tunnel syndrome: a case report
Mohammad Rahbar1, Neda Dolatkhah2
1Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Journal of Medical Case Reports
|March 5, 2023
Summary
Carpal tunnel syndrome can mimic vasculitis neuropathy. Early diagnosis of median nerve vasculitis mononeuropathy is crucial to prevent severe physical disabilities and guide appropriate treatment beyond carpal tunnel release.
Area of Science:
- Neurology
- Rheumatology
- Pathology
Background:
- Carpal tunnel syndrome (CTS) is a common mononeuropathy affecting the median nerve, causing wrist and hand pain, paresthesia, and sensory loss.
- CTS can be an early indicator of systemic vasculitis, potentially leading to significant physical disability.
Observation:
- A 27-year-old man with suspected CTS, unresponsive to conservative treatment, underwent surgery.
- Post-surgery, he developed progressive weakness and numbness in limbs, with electrodiagnostic findings inconsistent with typical CTS.
- Laboratory tests revealed elevated erythrocyte sedimentation rate, raising suspicion for vasculitis.
Findings:
- Nerve biopsy confirmed non-systemic vasculitic neuropathy, distinct from median nerve entrapment.
- Despite carpal tunnel release, the patient experienced worsening neurological deficits.
- A subsequent rehabilitation program led to functional recovery, with residual mild leg paralysis.
Implications:
- Clinicians should consider vasculitic neuropathy in patients presenting with carpal tunnel syndrome-like symptoms, especially when electrodiagnostic findings are atypical.
- Prompt diagnosis and treatment of median nerve vasculitis mononeuropathy are vital to avert severe physical impairments.
- This case highlights the importance of a high index of suspicion for vasculitis in neurological presentations that mimic common entrapment neuropathies.
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