CLINICAL CARE CONUNDRUMS A Multifaceted
نویسندگان
چکیده
Bilateral carpal tunnel syndrome should prompt consideration of systemic diseases that infiltrate or impinge both canals (eg, rheumatoid arthritis, acromegaly, hypothyroidism, amyloidosis), although it is most frequently explained by a bilateral repetitive stress (eg, workplace typing). The development of upper extremity weakness suggests that an alternative condition such as cervical myelopathy, bilateral radiculopathy, or a rapidly progressive peripheral neuropathy may be responsible for his paresthesias. It would be unusual for a central nervous system process to selectively cause bilateral upper extremity weakness. Occasionally, patients emerge from surgery with limb weakness caused by peripheral nerve injury sustained from malpositioning of the extremity, but this would have been evident immediately following the operation.
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