Palabras clave
Diagnóstico
Tratamiento
Revisión
Síndrome del túnel carpiano Carpal tunnel syndrome
Electrodiagnosis
Diagnosis
Treatment
Teview
Cómo citar
Resumen
El síndrome del túnel carpiano es el síndrome de atrapamiento del nervio periférico más común en todo el mundo; representa el 90% de todas las neuropatías, con una mayor prevalencia entre las mujeres. La presente revisión tuvo como objetivo proporcionar una visión general del síndrome. Los síntomas incluyen entumecimiento, hormigueo y/o dolor en la mano ventral-lateral, posiblemente atrofia y debilidad tenar, que generalmente empeora por la noche. El síndrome del túnel carpiano tiene un perfil de factores de riesgo que incluyen factores individuales, comorbilidades y ocupacionales que lo predisponen, estos se señalan brevemente. Esta revisión discute la anatomía del túnel carpiano, los mecanismos fisiopatológicos, sus causas, la presentación clínica del síndrome, así como la clasificación, diagnóstico y tratamiento de la condición. Finalmente, hay una escasez de evidencia sobre los mejores enfoques para la evaluación del síndrome del túnel carpiano y para guiar las decisiones de tratamiento. A pesar de que la mejor forma de integrar información clínica, funcional y anatómica para seleccionar opciones de tratamiento no ha sido identificada, los pacientes pueden ser diagnosticados rápidamente y responder bien al tratamiento.
Citas
Peters S, Page MJ, Coppieters MW, et al, Rehabilitation following carpal tunnel release (Review), Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD004158 https://doi.org/10.1002/14651858.CD004158.pub3
Moutasem S. Aboonq, Pathophysiology of carpal tunnel syndrome, Neurosciences 2015;20(1):4-9.
Newington L, Harris E, Walker-Bone K, Carpal tunnel syndrome and work, Best Practice & Research Clinical Rheumatology. 2015; 29(3):440-453 https://doi.org/10.1016/j.berh.2015.04.026
Bionka M. Huisstede, Jan Fride'n, et al, Carpal Tunnel Syndrome: Hand Surgeons, Hand Therapists, and Physical Medicine and Rehabilitation Physicians Agree on a Multidisciplinary Treatment Guidelined Results From the European HANDGUIDE Study, Archives of Physical Medicine and Rehabilitation 2014;95:2253-63. https://doi.org/10.1016/j.apmr.2014.06.022
Jonathan D. Gillig, Stephen D. et al, Acute Carpal Tunnel Syndrome A Review of Current Literature. Orthop Clin N Am. 2016; 47(3):599-607. https://doi.org/10.1016/j.ocl.2016.03.005
Kozak A, Schedlbauer G, Wirth T, et al, Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research, BMC Musculoskeletal Disorders. 2015;16:231. https://doi.org/10.1186/s12891-015-0685-0
Rempel D, Evanoff B, Amadio PC, et al. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health 1998;88:1447-51. https://doi.org/10.2105/AJPH.88.10.1447
Franklin G, Andrew S. et al, Work-Related Carpal Tunnel Syndrome Diagnosis and Treatment Guideline, Phys Med Rehabil Clin N Am. 2015; 26(3):523-537. https://doi.org/10.1016/j.pmr.2015.04.003
Giannini F, Cioni R, Mondelli M, et al., A new clinical scale of carpal tunnel syndrome: validation of the measurement and clinical-neurophysiological assessment, Clinical Neurophysiology. 2002;113(1):71-77. https://doi.org/10.1016/S1388-2457(01)00704-0
Middleton S, Anakwe R, Carpal tunnel Syndrome, BMJ. 2014;349:g6437. https://doi.org/10.1136/bmj.g6437
De Rijk MC, Vermeij FJ, Suntjens M, Et al., Does a carpal tunnel syndrome predict an underlying disease? J Neurol Neurosurg Psychiatry 2007;78:635-7. https://doi.org/10.1136/jnnp.2006.102145
Ortiz C, López M, Aproximación a valores de referencia de estudios electrofisiológicos para el diagnóstico de Síndrome de Túnel del Carpo,
Rev. salud pública. 2009;11(5):794-801. https://doi.org/10.1590/S0124-00642009000500012
American Academy of Physical Medicine and Rehabilitation, American Association of Electrodiagnostic Medicine, and American Academy of Neurology. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome (summary statement). Arch Phys Med Rehabil. 1994;75:124-125. https://doi.org/10.1016/0003-9993(94)90352-2
Padua L., Monaco M., Padua R., et al, Neurophysiological classification of tunnel syndrome: assessment of 600 symptomatic hands, Ital J. Neurol. Sci. 1997;18:145-150. https://doi.org/10.1007/BF02048482
Atroshi I, Gummesson C, Johnsson R, et al, Diagnostic properties of nerve conduction tests in population-based carpal tunnel syndrome. BMC Musculoskelet Disord. 2003;4:9. https://doi.org/10.1186/1471-2474-4-9
Bland JDP. A neurophysiological grading scale for carpal tunnel syndrome. Muscle Nerve 2000;23:1280-1283. https://doi.org/10.1002/1097-4598(200008)23:8<1280::AID-MUS20>3.0.CO;2-Y 4598(200008)23:8<1280::AID-MUS20>3.0.CO;2-Y
Stevens JC. AAEM minimonograph #26: The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997;20:1477-1486. https://doi.org/10.1002/(SICI)1097-4598(199712)20:12<1477::AID-MUS1>3.0.CO;2-5 org/10.1002/(SICI)1097-4598(199712)20:12<1477::AID-MUS1>3.0.CO;2-5
Leventoglu A, Kuruoglu R. Do electrophysiological findings differ according to the clinical severity of carpal tunnel syndrome? J Neurol Sci (Turkish) 2006;23:272-278. https://doi.org/10.1002/ppsc.200601066
Benjamin Sucher, Do, Grading Severity of Carpal Tunnel Syndrome in Electrodiagnostic Reports: Why Grading is Recommended, Muscle Nerve
;48: 331-333. https://doi.org/10.1002/mus.23824
Graham B, Peljovich A., Afra R, Et al, The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on Management of Carpal Tunnel Syndrome, J Bone Joint Surg Am.2016;98:1750-4. https://doi.org/10.2106/JBJS.16.00719
Padua L, Coraci D, Erra, et al, Carpal tunnel syndrome: clinical features, diagnosis, and Management, Lancet Neurol 2016; 15: 1273-84. https://https://doi.org/10.1016/S1474-4422(16)30231-9