[Vasomotor disorders of the hand and carpal tunnel syndrome]

Clinical electrophysiological and chronothermodynamic examinations were performed on 71 patients with paresthesiae and pain of the hands. In 35 patients, the electromyographic examination confirmed the diagnosis of carpal tunnel syndrome on the basis of clear signs of chronic compression of the median nerve at the carpal tunnel. In the other 36 patients, the electro-physiological findings were normal. Twenty-nine patients with bilateral (n = 24) or unilateral (n = 5) carpal tunnel syndrome, and 29 patients without, this syndrome had chronothermodynamic abnormalities demonstrating the vascular origin of the disorders of the hands; in 18 patients, a Raynaud's syndrome was suspected on the basis of severe dysthermia. In 7 patients, the origin of pain and paresthesiae remained unknown. This study shows that (i) vascular disorders of the hand are very frequent in patients with paresthesiae and pain of the hands and may mimic a carpal tunnel syndrome, and (ii) clinical examination is insufficient to assess the diagnosis of carpal tunnel syndrome. Before deciding on any kind of therapy, this diagnosis has to be assessed on electrophysiological and chronothermodynamic examinations performed according to precise protocols.