Comparisons of electrophysiological and clinical findings between young and elderly patients with Carpal Tunnel Syndrome

Abstract

Background: Few studies have been published on differences between young and old patients with Carpal Tunnel Syndrome regarding clinical and electrophysiological findings. We compared the findings in participants of two age ranges.

Methods: For one year from August 2016, we performed a two-group cross-sectional study in an outpatient clinic of physical medicine and rehabilitation at a University Hospital. Two samples of young and old women with a diagnosis of the syndrome without known risk factors affecting electrophysiological findings were selected. We measured sensory and motor amplitudes and latencies, the conduction velocity of the median nerve, severity, and recurrence of the manifestations, weakness, atrophy, and severity of the syndrome.

Results: We had two groups of 24 young (<35 years) and 24 old (>65 years) patients with CTS. Severity of symptoms was higher in young participants [Mean (SD) 3.0(0.6) vs. 2.0(0.8), P<0.001]. Muscular weakness was not different [young 2.6(0.88) vs. old 1.9(1.6), P=0.541]. Five young and nine old participants showed thenar wasting (P=0.104). The severity of CTS was similar (P=0.129). For the group young patients, mean sensory amplitude was higher [14.07(10.98) vs. 7.58(5.08), P=0.012], while mean latency was lower [3.86(0.57) vs. 5.15(1.17), P<0.001]. In motor studies, mean latency was more prolonged in the group old patients [3.86(0.57) vs. 5.15(1.17), P<0.001].

Conclusion: Clinical symptoms are more severe among young people, while the pathophysiological process is more intense in the elderly. Patients should not be clinically judged merely by subjective manifestations. Both diagnostic workup and treatment should be designed holistically with all the evidence taken into consideration.

Keywords: Carpal Tunnel Syndrome; Elderly; Electrodiagnostic studies; Young.