Carpel tunnel syndrome involving unaffected limbs of stroke patients

Background and Purpose-Stroke-induced hemiparesis involving the arm and han d results in regular, repeated overuse of the opposite hand and wrist. Beca use repetitive hand and wrist movement is a common cause of carpal tunnel s yndrome (CTS), we examined the nonparetic upper limb in stroke patients for evidence of CTS. Methods-We measured bilaterally sensory nerve conduction velocity (SNCV), m otor nerve conduction velocity (MNCV), sensory nerve action potentials (SNA P) at the wrist, palm-to-wrist distal sensory latency (DSL), palm-to-wrist SNAP, compound motor action potentials (CMAP), and distal motor latency (DM L) in stroke patients and control subjects. Controls were right-handed, gre ater than or equal to 65 years old, lucid, independent in their activities of daily living, and had no disease known to cause CTS. Stroke patients wer e divided into a functioning hand group (n = 61) and a disused hand group ( n = 71). All patients had hemiplegia. Results-Tinel's sign was observed on the nonparetic side in 57.7% of patien ts with a disused hand and in 31.1% of those with a functioning hand. All e lectrophysiological indices were significantly more abnormal on the nonpare tic side than on the hemiparetic side or in controls. Patients with a disus ed hand showed greater abnormality on the nonparetic side in SNCV, SNAP, pa lm-to-wrist DSL, DML, and CMAP than patients with a functioning hand. Conclusions-Overuse of the nonparetic hand and wrist of the nonparetic side may result in CTS in stroke patients, especially when the paretic hand is not functional. Wrist splinting or other prophylactic treatments beginning soon after stroke might help to prevent CTS.