Autonomic involvement in carpal tunnel syndrome – sympathetic skin response and skin temperature

Özet

Objective: Some studies found autonomic involvement in carpal tunnel syndrome (CTS). The purpose of this study is to investi- gate whether autonomic involvement is a consequence of the primary destruction of autonomic fibers or a response to sensory fibers’ destruction as in complex regional pain syndrome type I. Methods: Sympathetic skin response (SSR) and skin temperature measurements (STM) in the median and ulnar sides of both hands in 29 CTS patients (unilateral n=16) and the 23 healthy volunteers were recorded. CTS was categorized in three groups based on the results of electrophysiological tests. Results: Mild CTS patients (n=28), moderate CTS patients (n=9), severe CTS patients (n=5) and control group (n=46) were eval- uated. The temperature measurements of both the ulnar and the median sides in severe CTS patients were consistently higher than the others. The temperature of distal phalanx of the 2nd finger in patients with severe CTS were significantly higher than the control group and the mild CTS patients (p 0.05). Conclusion: Autonomic involvement in CTS may be speculated that the compression severe enough to result in permanent electrophysiological changes may lead to an irritation in A delta and C fibers that can trigger a reflex sympathetic response when it reaches a certain level of intensity. This hypothesis may also help explain the presence of positive autonomic findings such as increased temperature or hyperemia.