Ahmad Furqan, Naeem Kasuri, Athar Javed, Javed Iqbal, Haroon Khan, Mohsin Zaheer.
Frequency of carpal tunnel syndrome in patients of diabetic peripheral neuropathy.
Pak J Neurological Sci Jan ;7(4):6-11.

Background: A variety of focal neuropathies (Carpel Tunnel Syndrome; Radial or Common Peroneal Neuropathies) are seen in diabetics. Commonest focal neuropathy is ‘Carpal Tunnel Syndrome (CTS)’. It may be difficult to diagnose CTS in patients with co-existent ‘Diabetic Peripheral Neuropathy (DPN)’. Aim: To study the frequency of ‘CTS’ in patients symptomatic of ‘DPN’. Methodology: On the basis of non-probability purposive sampling, a cross sectional study was conducted in which 113 patients symptomatic of DPN were subjected to electrophysiology. Analysis of data was done using Independent-Samples T-Test. Results: Out of 113 diabetics, 48 (42.5%) were male and 65 (57.5%) were female. Mean age at presentation of CTS was earlier in female (51.3 yrs.) than in male gender (52.1 yrs.). On electrophysiology, a total of 15/113 cases (13.27%) of CTS were found. Frequency of CTS was statistically significant (p<0.020) in female gender (12/15 cases i.e. 80%) than in males (03/15 cases i.e. 20%). There was no marked difference (p<0.796) in the frequency of U/L (8/15 cases i.e. 53.33%) vs. B/L CTS (7/15 cases i.e. 46.67%). Right sided CTS (7/8 cases i.e. 87.5%) was frequent (p<0.000) than left sided (1/8 case i.e. 12.5%). CTS as part of diabetic polyneuropathy (11/15 cases i.e. 73.33%) was statistically significant (p<0.000) than CTS presenting as diabetic mononeuropathy (4/11 cases i.e. 26.67%). Sensory-motor mixed polyneuropathy (7/11 cases i.e. 46.66%) was the commonest electrophysiological pattern. Males developed symptomatic CTS earlier (1.48 mean yrs. earlier) than females. Conclusion: The study revealed that CTS constituted 13.27% of all types of diabetic peripheral neuropathies. Not only mean age at presentation of CTS was earlier but female gender had a statistically significant (80% cases) predilection for CTS. U/L CTS was mainly right sided. In 26.67% diabetics, CTS presented as mononeuropathy without concomitant evidence of peripheral polyneuropathy. Sensory-motor mixed neuropathy was the commonest electrophysiological pattern seen in diabetics with CTS. Males developed neuropathy earlier than females.

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