Vnitr Lek 1993, 39(5):476-480

[The carpal tunnel syndrome, its diagnosis and therapy].

V Bártová: Hemodialyzacní stredisko II. interní kliniky, FNsP, Praha.

Secondary amyloidosis is a complication typical for patients on long-term haemodialysis (HD). The first clinical signs are usually shoulder joint pain and CTS. We have questioned 74 patients who were on regular HD treatment and divided them into 3 groups according to the length of HD. Group I--on HD for 1-4 years: there were 35 patients in this group, 15 of them (i.e. 43%) had shoulder joint pain and/or CTS. None of these patients had such symptoms, which would require surgical treatment. Group II--on HD for 5-9 years: there were 22 patients in this group, 15 of them (i.e. 68%) had shoulder joint pain and/or CTS. 3 patients from this group had severe night pain and were therefore indicated for surgical treatment for CTS, each of them on 1 hand only. In 2 cases there was amyloid present in the histological examination. Group III--on HD for over 10 years: there were 17 patients in this group, 13 of them (i.e. 76%) had shoulder joint pain and/or CTS. 5 patients from this group were operated on both hands for severe night pain due to carpal tunnel syndrome. Only 1 patient had positive amyloid on both hands in the histological examination. All the 8 patients (i.e. 13 hands) were examined by EMG before the operation, showing reduction of motor conduction on n. medianus by 30.7 +/- 15.1%. After the operation the EMG control was done in 4 patients (7 hands), showing no improvement in 2 cases and in 5 cases the conduction on the n. medianus was found to be in the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)