Compression of the median nerve in the carpal tunnel in a 16 year-old: A case report
DOI:
https://doi.org/10.1016/j.rccot.2019.12.002Keywords:
carpal tunnel syndrome, children, electrodiagnosis, treatment, ganglion, surgical releaseAbstract
Background: Carpal tunnel syndrome is the most frequent nerve compression disorder of the upper limb. It is uncommon in children and in the majority of cases it is mainly associated with an alteration of genetic origin such as mucopolysaccharidosis. It can be of an idiopathic, traumatic, infectious origin, associated with systemic infectious diseases and occupation of the carpal tunnel.
Case report: The case is presented on a 16 year-old female patient with pain in the left hand for a year, with hypoesthesia and paraesthesia of the fingertips, with no previous traumatic event. The physical examination was not conclusive, although a nerve compression disorder was highly suspected. Using electrodiagnosis and imaging, the diagnosis of carpal tunnel syndrome was made that was secondary to a ganglion identified on the floor of the tunnel. The most recommended treatment in this type of condition is surgical release and resection of the ganglion.
Discussion: Carpal tunnel syndrome in children and adolescents is difficult to diagnose due to the wide range of symptoms. Once the carpal tunnel syndrome has been diagnosed, the most recommended treatment according to this cause is the surgical release of the carpal tunnel and resection of the ganglion. Carpal tunnel syndrome is an infrequent condition in children. Complementary studies should be performed to make an adequate diagnosis and an effective treatment. After the release of the carpal tunnel it rare for the neurological symptomatology to persist.
Evidence Level: IV
Downloads
References
Kyle D, Bickel. Carpal tunnel syndrome. J Hand Surg Am [Internet]. 2010;35A:147-52, https://doi.org/10.1016/j.jhsa.2009.11.003
Davis L, Vedanarayanan VV. Carpal tunnel syndrome in children. Pediatr Neurol [Internet]. 2014;50:57-9, https://doi.org/10.1016/j.pediatrneurol.2013.08.019
Potulska-Chromik A, Lipowska M, Gawel M, Ryniewicz B, Maj E, Kostera-Pruszczyk A. Carpal tunnel syndrome in children. J Child Neurol [Internet]. 2014;29:227-31. https://doi.org/10.1177/0883073813504458
Lamberti PM, Light TR. Carpal tunnel syndrome in children. Hand Clin. 2002;18:331-7. https://doi.org/10.1016/S0749-0712(01)00010-5
Wong AH, Horowitz MI, Watson SB, Watson HK. Missed Childhood-Onset Carpal Tunnel Syndrome Diagnosed as Chronic Pain: Case Report. J Hand Surg Am [Internet]. 2012;37:2004-6. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0363502312010167. https://doi.org/10.1016/j.jhsa.2012.06.040
Van Heest AE, House J, Krivit W, Walker K. Surgical treatment of carpal tunnel syndrome and trigger digits in children with mucopolysaccharide storage disorders. J Hand Surg Am. 1998;23:236-43. https://doi.org/10.1016/S0363-5023(98)80120-2
Cruz Martinez A, Arpa J. Carpal tunnel syndrome in childhood: study of 6 cases. Electroencephalogr Clin Neurophysiol. 1998;109:304-8. https://doi.org/10.1016/S0924-980X(98)00026-5
Mohamed A, Rosalie S, Taylor K, Fink M, Coombs C, Ryan M, et al. Carpal tunnel syndrome secondary to ganglion cyst in a child. J Child Neurol [Internet]. 2011;26:630-3. Available from: http://jcn.sagepub.com/content/26/5/630.full.pdf. https://doi.org/10.1177/0883073810387299
Van Meir N, De Smet L. Carpal tunnel syndrome in children. J Pediatr Orthop B [Internet]. 2005;14:42-5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15577306. https://doi.org/10.1097/01202412-200501000-00007
Algahtani H, Watson BV, Thomson J, Al-Rabia MW. Idiopathic bilateral carpal tunnel syndrome in a 9-month-old infant presenting as a pseudo-dystonia. Pediatr Neurol [Internet]. 2014;51:147-50, https://doi.org/10.1016/j.pediatrneurol.2014.01.047
Duru NS, Acar H, Ayta S, Elevli M. Bilateral carpal tunnel syndrome in a child with type 1 diabetes mellitus. Neurol India. 2010;58:136-7. https://doi.org/10.4103/0028-3886.60401
Galloway KM, Greathouse DG. Carpal Tunnel Syndrome in an Adolescent With Obesity. Pediatr Phys Ther [Internet]. 2016;28:248-52. Available from: http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00001577-201628020-00027. https://doi.org/10.1097/PEP.0000000000000236
Sando IC, Ono S, Chung KC. Schwannoma of the hand in an infant: Case report. J Hand Surg Am [Internet]. 2012;37: 2007-11, https://doi.org/10.1016/j.jhsa.2012.07.011
Sakalli H, Erinanc H, Dursun R, Baskin E. An unusual presentationof herpes simplex virus type 1infection in a child. Case Rep Dermatol. 2013;5:52-7. https://doi.org/10.1159/000348239
Batdorf NJ, Cantwell SR, Moran SL. Idiopathic Carpal Tunnel Syndrome in Children and Adolescents. J Hand Surg Am [Internet]. 2015;40:773-7. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0363502315000854. https://doi.org/10.1016/j.jhsa.2015.01.026
Illeez OG, Ozkan FU, Ozkaya O, Aktas I, Ozkan K. Bilateral idiopathic carpal tunnel syndrome in a 4-year-old girl. J Trop Pediatr. 2017;63:78-81. https://doi.org/10.1093/tropej/fmw047
Leduc A, Perrot P, Truffandier MV, Bellier-Waast F, Duteille F. Syndrome du canal carpien chez l'enfant. À propos de 10 cas cliniques. Ann Chir Plast Esthet [Internet]. 2014;59:155-60, https://doi.org/10.1016/j.anplas.2013.12.001
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
Derechos de autor
Los autores aceptar transferir a la Revista Colombiana de Ortopedia y Traumatología los derechos edición, publicación y reproducción de los artículos publicados. La editorial tiene el derecho del uso, reproducción, transmisión, distribución y publicación en cualquier forma o medio. Los autores no podrán permitir o autorizar el uso de la contribución sin el consentimiento escrito de la revista. Una vez firmada por todos los autores, la carta de Cesión de derechos debe ser cargada en el paso dos del envío.
Aquellos autores que tengan publicaciones en esta revista aceptan los siguientes términos:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web), lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
