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Long term effect of local corticosteroid injection for carpal tunnel syndrome: A relation with electrodiagnostic severity.
MedLine Citation:
PMID:  21962473     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Carpal 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. METHODS: Assessment 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 40mg methylprednisolone. RESULTS: Local 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 6months was seen in 132 patients (63%), longer than 12months in 102 patients (48%), and longer than 18months in 71 patients (34%). Only severity of electrodiagnostic testing was a predictor of outcome. The median time until treatment failure was 15months for mild, 5months for moderate and 4.5months for severe CTS (logrank test p=0.02). CONCLUSION: Patients with an electrodiagnostically mild CTS (i.e., abnormal comparative tests or prolonged median DSL>3.5ms but normal median DML) are good candidates for a local steroid injection with 50% having a good long term effect for more than 15months. SIGNIFICANCE: This study shows that the EMG severity of CTS is an important prognostic factor for the long term effect of a local steroid injection.
Leo H Visser; Quang Ngo; Sascha J M Groeneweg; Geert Brekelmans
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-28
Journal Detail:
Title:  Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology     Volume:  -     ISSN:  1872-8952     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-10-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883319     Medline TA:  Clin Neurophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Department of Neurology and Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, The Netherlands.
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