[Carpal tunnel syndrome in pregnancy]

Analysis of 20 patients with 34 carpal tunnel syndromes (CTS) showed that CTS in pregnancy occurs generally between 30 and 40 years of age in both primiparous (n = 7) and multiparous (n = 13) women. The syndrome usually is most bothersome during the third trimester of pregnancy (n = 10) or during puerperium (n = 7). Clinically, CTS in pregnancy is very different from idiopathic CTS. Paresthesia frequently occurs during the daytime or is permanent and usually more troublesome than phenomena occurring at night. The Weber and Semmes Weinstein test, an objective measurement of hypoesthesia, is often positive. The electrophysiological findings are more serious and are different from those observed in idiopathic CTS. Mean nerve conduction velocity in the median nerve measured at the wrist is comparable in the two forms, but the frequency of neurogenic pattern is higher in pregnancy CTS. Conduction blocks are also much more frequent and concern motor (18%) or sensory (44%) conduction. These conduction blocks result from acute compression of the nerve due to hormone-dependent tenosynovitis. Infiltrations are effective in 85% of the cases, but in some forms with very serious axonal loss, surgical release is justified.