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Journal of the Korean Neurological Association 2010;28(4): 277-282.
당뇨병 환자에게 동반된 손목굴증후군의 임상적 특징
김선영, 고민수 권지현 서정규 a
울산대학교 의과대학 신경과학교실, 경북대학교 의과대학 신경과학교실 a
Clinical Characteristics of Carpal Tunnel Syndrome in Patients With Diabetes
Sun-Young Kim
Department of Neurology, University of Ulsan College of Medicine, Ulsan, Korea
Background: The clinical symptoms and signs of carpal tunnel syndrome (CTS) were investigated in patients with diabetes.
Methods: The nondominant hands of 105 consecutive patients with diabetes or CTS were divided into three groups: diabetic CTS, diabetic non?CTS, and nondiabetic CTS. The symptoms of CTS (pain, paresthesias, numbness, awakening, weakness, and clumsiness) were scored using the Global Symptom Score. The following signs of CTS were evaluated: Tinel’s sign, Phalen’s sign, thenar atrophy, and weakness of the abductor pollicis brevis (APB). The severity of the diabetic neuropathy was evaluated using the Michigan Diabetic Neuropathy Score. The score on the neuropathy scale, number of nerves involved, and the score for each CTS symptom and sign were compared among the groups.
Results: The duration of diabetes was longer (p=0.000) and diabetic polyneuropathy was more severe (p=0.014) in the diabetic CTS group than in the diabetic non?CTS group. The mean scores for pain and paresthesias were lower in the diabetic CTS group than in the nondiabetic CTS group (p=0.047 and p=0.049, respectively), whereas the mean scores for numbness and weakness did not differ significantly between these two groups (p=0.528 and p=0.638, respectively). In addition, APB weakness was more frequent whereas Phalen’s sign was less frequent in the diabetic CTS group than in the nondiabetic CTS group (p=0.002 and p=0.02, respectively).
Conclusions: Patients with diabetic CTS complained less of pain and paresthesias, but their intrinsic hand function did not differ significantly from that of patients with nondiabetic CTS. Key Words: Carpal tunnel syndrome, Diabetic polyneuropathy, Neuropathy scale, Tinel’s sign, Phalen’s sign, Paresthesias