A Electrodiagnostic Study on Relationship of the Double Crush Syndrome to Carpal Tunnel Syndrome : a Preliminary Study

J Korean Neurol Assoc > Volume 18(1); 2000 > Article

Journal of the Korean Neurological Association 2000;18(1): 68-72.

수근관 증후군과 이중압궤 증후군과의 관련성에 대한 전기진단학적 예비연구

하충건, 심용수 ·김병모*

인하대학교 의과대학 신경과학교실,한일병원 신경과*

A Electrodiagnostic Study on Relationship of the Double Crush Syndrome to Carpal Tunnel Syndrome : a Preliminary Study

Choong-Kun Ha, M.D., Yong-Soo Shim, M.D., Byung-Mo Kim, M.D.*

Department of Neurology, Inha University College of Medicine Department of Neurology, Hanil General Hospital, Seoul, Korea*

Abstract

B a c k g r o u n d : The concept of “double crush syndrome (DCS)”-a proximal compressive lesion making the distal nerve more vulnerable to injury-is an intriguing hypothesis. However, recent studies did not show unitary results. This study was preliminarily undertaken in order to clarify the causal relationship of proximal compressive lesion and carpal tunnel syndrome (CTS) in an electrophysiologic aspect. M e t h o d s : In the period between June 1998 and June 1999 there were 24 patients with CTS(33 limbs with CTS). With these CTS patients, thorough electrodiagnostic studies were performed to discover coexisting proximal compressive lesions along the median nerve and its corresponding cervical root lesions. R e s u l t s : In 10 of these limbs (30%), there was a electrodiagnostically-proven coexisting proximal compressive lesion(all cervical radiculopathies). But only 1 limb (3%) had an anatomically responsible association. Finally only 1 limb (3%) with CTS had a possibility of DCS. C o n c l u s I o n s : CTS and cervical radiculopathy are common disorders, so there is a high possibility of coexisting as a double primary lesion without a pathophysiological relationship. Our results do not support the double crush hypothesis. However, the possibility of a reversed double crush syndrome is suggested. J Korean Neurol Assoc 18(1):68~72, 2000 Key Words : Carpal tunnel syndrome, Cervical radiculopathy, Double crush syndrome, Reversed double crush syndrome