In this study, we aimed to reevaluate and explicate the etiological factors, demographic

TEZ10099Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2013.Kaynakça (s. 37-41) var.x, 46 s. : res. (bzs. rnk.), tablo ; 29 cm.Giriş ve Amaç: Biz bu çalışmada Çukurova Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı polikliniğine el, ön kol ve kolda ağrı, elde uyuşma, zayıflık ve beceriksizlik yakınması ile başvuran ve karpal tünel sendromu (KTS) ön tanısı düşünülen hastalarda etyolojik nedenlerin, demografik ve klinik özelliklerin, elektrofizyolojik olarak elde edilen bulguların tekrar gözden geçirerek değerlendirilmesini ve irdelenmesini amaç edindik. Gereç ve Yöntem: Çalışmaya hastanın verdiği öyküye dayanarak KTS ön tanısı olan 60 kişi dahil edildi. Hastalar öncelikli olarak demografik ve etyolojik nedenlerin irdelenmesi için yaş, cinsiyet, el dominansı, meslek, yapmış ise doğum sayısı, boy, kilo, vücut kitle indeksi, mevcut yakınma, yakınma süresi, yakınmanın başladığı el, aile öyküsü, özgeçmiş ve kullandığı ilaçları KTS klinik değerlendirme formu ile detaylı olarak sorgulandılar. Yine etyolojide yer alan bazı hastalıklar ise biyokimyasal ve hematolojik testler (hemogram, hemotokrit, açlık kan şekeri, tiroid fonksiyon testleri, hemoglobin A1c gibi.) ile değerlendirildi. KTS klinik değerlendirme formu ile değerlendirilen ve muayenesi tamamlanan hastalarda yüzeyel elektrot ile her iki üst ekstremitenin sinir ileti çalışması yapıldı. Bulgular: KTS ön tanılı 60 hastada yapılan elektrofizyolojik inceleme sonucunda % 66,7 sinde KTS saptanmıştır. KTS saptanan hastalarda bulgular % 42,5 oranında bilateraldir. Kadın cinsiyet, obesite, yüksek vücut kitle indeksi (VKİ), ileri yaş ve tekrarlayıcı el hareketleri KTS saptanan hastalarda risk faktörleridir. Diyabetes mellitus (DM) ve gebelik gibi medikal durumların etyolojide yer aldığı gösterilmiştir. Kesin tanı ENG ile konulur. Subklinik dönemde KTS tanısı koyabilmek için EMG-ENG iki elde de çalışılmalıdır. Sonuç: KTS gelişiminde; kadın cinsiyet, obesite, yüksek vücut kitle indeksi (VKİ), ileri yaş ve tekrarlayıcı el hareketleri önemli risk faktörleridir. Tanı; anamnez, fizik muayene bulguları, labaratuar ve elektrofizyolojik incelemeler sonucu konulur. En sık görülen yakınma uyuşmadır. Ancak provokatif teslerin pozitifliği ve atrofi varlığı tanı koymada önemli bulgulardır. Subklinik dönemdeki KTS tanısı sadece EMG-ENG ile konulduğundan elektrofizyolojik inceleme bilateral olarak yapılmalıdır.Introduction and Objective: In this study, we aimed to reevaluate and explicate the etiological factors, demographic and clinical features and electrophysiological findings of the patients, who were referred to the Policlinic of the Department of Neurology of the School Of Medicine of Çukurova University, with the symptoms consisting of numbness of hands, paresthesia, tingling sensation and pain localized to hand, antebrachial or brachial regions and with the initial diagnotic impression of “carpal tunnel syndrome” (CPS). Material and Methods: 60 patients with the initial diagnostic impression of carpal tunnel syndrome were enrolled in the study, based upon their medical history. To evaluate the demographical and etiological factors properly, a detailed anamnesis of the patients were taken which covered the age, sex, dominant hand, height, weight, body mass index (BMI), present symptoms, duration of symptoms, the hand inwhich the first symptoms were observed, personal and familial medical histories and medication history by the use of CTS evaluation forms. Medical conditions, roles of which are established in the CTS pathogenesis, are evaluated via biochemical and hematological tests (i.e., hemogram, fasting blood glucose, thyroid function tests, Hemoglobin A1C). After evaluation with CTS forms and clinical examination, nerve conduction in the patients’ bilateral upper extremities were evaluated via the use of surface electrodes. Findings: According to the electrophysiological findings, we observed that 66:7% of the 60 patients with the initial diagnosis of CTS, had CTS.42:5% of these patients had bilateral CTS. Female gender, obesity, high BMI, old age and repetetive hand movements were observed risk factors. Also, there was a high incidence of CTS in the patients with Diabetes Melliyus (DM) and pregnant women. The definitive diagnosis for CTS is established only with EMG-ENG studies. To establish the CTS diagnosis during the subclinical phase, both hands should be evaluated by EMG-ENG. Conclusion: Female gender, obesity, high BMI, old age and repetitive hand movements seem to play an important role in the pathogenesis of CTS. Diagnosis of CTS is established by anamnesis, physical examination, electrophysiological and other laboratory tests. The most observed symptom is numbness. Another quite common symptom is paresthesia. In the presence of these symptoms, muscle atrophy and positive results tı provacative tests are valuable to establish the diagnosis. It is very important to keep in mind that during the subclinical phase, it is only possible to establish a CTS diagnosis via EMG, so during this phase, EMG-ENG must be performed for both of the upper extremities

The Relationship Between Body Mass Index and Mononeuropathies

Aim: The study aimed to find out whether there is a relationship between the mononeuropathies of the median, ulnar, radial, peroneal, and sciatic nerves and body mass index (BMI). Material and Methods: Patients whose clinical and electrodiagnostic findings were compatible with carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow (UNE), radial neuropathy at the spiral groove (RNS), peroneal neuropathy at the fibular head (PNFH), and sciatic injury due to intramuscular injection (SNIII) were included in this retrospective cohort study. In addition, controls whose clinical and electrodiagnostic features were not compatible with mononeuropathy were included in the study. The BMI values of all participants were analyzed. Results: One hundred thirty-one CTS patients, 53 UNE patients, 6 RNS patients, 25 PNFH patients, 72 SNIII patients, and 53 controls were included in the study. The BMI of CTS patients was higher than the BMI of controls (p<0.001), PNFH patients (p<0.001), and SNIII patients (p<0.001). The BMI of SNIII patients was lower than the BMI of controls (p<0.001), CTS patients (p<0.001), and UNE patients (p<0.001). The BMI of PNFH patients was lower than that of CTS patients (p<0.001) and UNE patients (p=0.004). No significant correlation was found between BMI values and electrodiagnostic classification of mononeuropathies in the groups. Conclusion: This study showed that high BMI is a risk factor for CTS and low BMI is a risk factor for SNIII. There may also be a relationship between BMI and PNFH, but this should be confirmed by further studies