Severe carpal tunnel
Hello, I have suffered with cts for a few years, recently underwent bilateral endoscopic surgery. I am curious about the severity of my cts, the recovery time and possible permanent damage. As the doctor who did the nerve study, prior to cts surgery, said to me I don't know how you are even functioning on a daily basis. Examination: No signs of atrophy No signs of fasciculations Cystic mass in right volar wrist Negative Spurling b/l MME: 5/5 in the Cs-TI myotomes b/l Reflexes 2/4 in the biceps, triceps and brs Negative Hofimann b/1 Positive Phalen b1 Positive Tinel at the right mid-volar proximal palm Negative Tinel at the left mid-volar proximal palm Negative Tinel at the elbows EMG & NCV Findings: Evaluation of the Left Median Motor nerve showed prolonged distal onset latency (6.0 ms). The Right Medlan Motor nerve showed prolonged distal onset latency (7.0 ms). The Left Median And Sensory nerve showed prolonged distal peak latcney (6.0 ms) and decreased conduction velocty (Wrist-2nd Digit, 23.3 m/s). The Right Median Anti Sensory nerve showed no response (Wrist). The Left Palmar Orho Sensory nerve showed prolonged distal peak latency (Median Palm, 4.0 ms). All remainlng nerves (as indicated in the folowing tables) were within normal limits. Left vs. Right side comparison data for the Median Motor nerve indiçates abnornal L-R latency difference (1.0 ms). All remaining left vs. right side differences were within normal limits. Needle evaluation of the Right Abd Poll Brev muscle showed increased insertional activity, incressed spontaneous actívity, and diminished recruitment. All remaining muscles (as indicated In the following table) showed no evidence of elecrical instabiity. IMPRESSIONS: 1.The electrodiagnostic study reveals a severe demyelinating and acute/chronic Axonal median neuroputhy at the right carpal tunnel. 2. The electrodiagnostic study reveals a severe demyelinating sensory and motor median neuropathy at the left carpal tunnel. 3. There is no elcctrodiagnostic evidence of any other focal nerve entrapment i.e. ulnar or acute cervical motor raiculopathy in either upper extremity at this time. This test docs not rule out pure dorsal root ganglion compromise (radiculitis without motor radiculopathy). Surgery notes: I made a transverse incision proximal to the wrist crease and ulnar to the pamaris longus. I dissected down to the antebrachial fascia, which was opened with a distaly-based U-shaped flap. The carpal tunnel was prepared using dilators and l scraper. The endoscope was inserted. There was excelent visuaization of the transverse carpal as well as the median nerve. She did have a very tight carpal canal. From distal to proximal, the ligament was released using the endoscope blade in line with the fourth metacarpal. The patient had a relatively large palmaris brevis, which was also released along the ulnar aspect until the palmar fascia could be visualized. After the endoscope was withdrawn, the more proximal antebrachial fascia was released under direct vision using scissors for about 2 cm.