A 45-year-old woman presents with a complaint of intermittent numbness and tingling
in the right hand that started spontaneously about 6 months previously and bothers
her more at night than during the day. The numbness wakes her from sleep nearly every
night. The sensory disturbance involves the index, middle, and ring fingers and is
most pronounced in the middle finger. There is no atrophy of the intrinsic musculature,
including the thenar eminence, and she has strong palmar abduction of the thumb. Two-point
discrimination is normal. There is a positive Tinel sign to percussion over the median
nerve at the carpal tunnel. The Phalen test is positive. Her family physician has
already obtained electrodiagnostic tests, which show that median nerve sensory conduction
velocity is decreased across the carpal tunnel. At this point, the patient has not
received any treatment for these symptoms.
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Article info
Publication history
Accepted:
January 7,
2009
Received:
January 6,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2009 Published by Elsevier Inc.
