Etiology of Carpal Tunnel Syndrome in a Large Cohort of Children
Christina T. Rüsch,
Ursula Knirsch,
Daniel M. Weber,
Marianne Rohrbach,
André Eichenberger,
Jürg Lütschg,
Kirsten Weber,
Philip J. Broser,
Georg M. Stettner
Affiliations
Christina T. Rüsch
Neuromuscular Center Zurich and Department of Pediatric Neurology, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
Ursula Knirsch
Neuromuscular Center Zurich and Department of Pediatric Neurology, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
Daniel M. Weber
Division of Hand Surgery, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
Marianne Rohrbach
Division of Metabolism, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
André Eichenberger
Division of Radiology, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
Jürg Lütschg
Division of Pediatric Neurology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
Kirsten Weber
Division of Hand Surgery, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
Philip J. Broser
Division of Pediatric Neurology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
Georg M. Stettner
Neuromuscular Center Zurich and Department of Pediatric Neurology, University Children’s Hospital Zurich, University of Zurich, 8032 Zurich, Switzerland
(1) Background: Carpal tunnel syndrome (CTS), a compressive mononeuropathy of the median nerve at the wrist, is rare in childhood and occurs most frequently due to secondary causes. (2) Methods: Medical history, electrodiagnostic findings, and imaging data of patients with CTS from two pediatric neuromuscular centers were analyzed retrospectively. The etiology of CTS was investigated and compared with the literature. (3) Results: We report on a cohort of 38 CTS patients (n = 22 females, n = 29 bilateral, mean age at diagnosis 9.8 years). Electrodiagnostic studies of all patients revealed slowing of the antidromic sensory or orthodromic mixed nerve conduction velocities across the carpal tunnel or lack of the sensory nerve action potential and/or prolonged distal motor latencies. Median nerve ultrasound was diagnostic for CTS and confirmed tumorous and vascular malformations. Etiology was secondary in most patients (n = 29; 76%), and mucopolysaccharidosis was the most frequent underlying condition (n = 14; 37%). Idiopathic CTS was rare in this pediatric cohort (n = 9; 24%). (4) Conclusion: Since CTS in childhood is predominantly caused by an underlying disorder, a thorough evaluation and search for a causative condition is recommended in this age group.
