Abstract

Introduction: Carpal tunnel syndrome (CTS) may be defined as the compression of the median nerve at the wrist (carpal tunnel) in absence of an obvious injury, trauma or surgery. This is the commonest entrapment neuropathy.

Methods: This prospective case-control study was undertaken in the Department of Neurology (outdoor and electrophysiology centre), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during period from January to December, 2005. The objective of this study was to observe the efficacy of short-term low-dose steroid in mild to moderate idiopathic carpal tunnel syndrome. Total number of 60 respondents consisting of 30 subjects as control and 30 subjects as case, who were clinically and electrodiagnostically diagnosed as a CTS. The control and case respondents were age, sex and socioeconomic status matched. The clinical details and investigations of the respondents were reviewed. Data were recorded in predesigned proforma.

Out of 30 control and 30 cases, 8 (26.7%) were male and 22 (73.3%) female in each group. Majority of the cases presented at fourth to fifth decade of life.

Patients having history of diabetes mellitus, hypothyroidism, rheumatoid arthritis and cervical spondylitis were excluded from the study.

Mean (+ SD) age of the study subjects was 39.47 + 7.90 years. Females were affected more than male. All the subjects underwent GSS (global symptoms score) by questionnaire and median and ulnar nerve conduction scoring in the conventional way following guidelines of the American Academy of Electrodiagnostic Medicine.

Results: After treatment with short-term low-dose oral prednisolone, GSS improved in 56.3% and electrophysiological parameters found to be improved significantly. These results were compared with those of the western and Indian subcontinent studies and found to be similar and consistent.

Keywords: Carpal tunnel syndrome (CTS), Short term low dose oral steroid, Diabetes mellitus, GSS (global symptoms score).