| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3043616 | Clinical Neurophysiology | 2012 | 4 Pages |
ObjectiveCarpal tunnel syndrome (CTS) is a common entrapment neuropathy. A local corticosteroid injection at the carpal tunnel inlet is often given to reduce the signs and symptoms. The long term effect of a local corticosteroid injection is not known yet. The aims of the study were to assess the long term effect of a local corticosteroid injection and the rognostic factors.MethodsAssessment of 419 consecutive patients, seen between November 2004 and November 2007 at our Neurology out-patient clinic. After confirmation of the diagnosis CTS the treating neurologist decided on the patients eligibility for a local corticosteroid injection, containing 40 mg methylprednisolone.ResultsLocal corticosteroid injection was given to 273 of the 419 patients with CTS (65%), 122 (29%) were treated surgically and 24 (6%) were treated by another therapy. Of the 273 patients long term follow-up was available for 211 (77%) patients. A beneficial effect of more than 6 months was seen in 132 patients (63%), longer than 12 months in 102 patients (48%), and longer than 18 months in 71 patients (34%).Only severity of electrodiagnostic testing was a predictor of outcome. The median time until treatment failure was 15 months for mild, 5 months for moderate and 4.5 months for severe CTS (logrank test p = 0.02).ConclusionPatients with an electrodiagnostically mild CTS (i.e., abnormal comparative tests or prolonged median DSL > 3.5 ms but normal median DML) are good candidates for a local steroid injection with 50% having a good long term effect for more than 15 months.SignificanceThis study shows that the EMG severity of CTS is an important prognostic factor for the long term effect of a local steroid injection.
► The long term effect and prognostic factors of one local corticosteroid injection were assessed in 211 patients with CTS. ► A beneficial effect of more than 6 months was seen in 132 patients (63%), and longer than 12 months in 102 patients (48%). ► Only EMG severity was a predictor of outcome.
