Medicina

Carpal tunnel syndrome (CTS), or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness inthe hand. Night symptoms and waking up at night is a characteristic of established carpal tunnel syndrome. They can be managed effectively with night-time wrist splinting in most patients. Many peoplewho have carpal tunnel syndrome have gradually increasing symptoms over time. The first symptoms of CTS may appear when sleeping, and typically include numbness and paresthesia (a burning andtingling sensation) in the thumb, index, and middle fingers, although some patients may experience symptoms in the palm as well.[3] These symptoms appear at night because people tend to bend their wristswhen they sleep, which further compresses the carpal tunnel. Patients may note that they "drop things". It is unclear if carpal tunnel syndrome creates problems holding things, but it does decreasesweating, which decreases friction between an object and the skin. In early stages of CTS individuals often mistakenly blame the tingling and numbness on restricted blood circulation. They may also be atease and accepting of the symptoms and believe their hands are simply “falling asleep”. In chronic cases, there may be wasting of the thenar muscles (the body of muscles connected to the thumb),weakness of palmar abduction of the thumb (difficulty bringing the thumb away from the hand). Unless numbness or paresthesia are among the predominant symptoms, it is unlikely the symptoms are primarilycaused by carpal tunnel syndrome. In effect, pain of any type, location, or severity with the absence of significant numbness or paresthesia is not likely to fall under this diagnosis. Carpal tunnelsyndrome can be misdiagnosed, and other syndromes can be misdiagnosed as carpal tunnel syndrome. A nerve conduction study or referral to a neurologist may be of benefit in clarifying the diagnosis....