Autonomic dysfunction in idiopathic carpel tunnel syndrome

While the sensorimotor features of carpal tunnel syndrome (CTS) are well kn own, a prospective, systematic study of autonomic disturbances in CTS is la cking. Of 139 limbs with CTS (76 patients), autonomic symptoms were reporte d in 76 (47 patients). Of these, 59% consisted of swelling of the fingers, 39% dry palms, 33% Raynaud's phenomenon, and 32% blanching of the hand. Sym pathetic skin response (SSR) had a sensitivity/specificity ratio of 34/89% in CTS with autonomic symptoms. The presence of autonomic disturbances was significantly associated with female gender (odds ratio 4.06, 95% CI 1.5-11 .4, P = 0.007), SSR abnormalities (odds ratio 4.3, 95% CI 1.6-11.4, P = 0.0 03), and severity of electromyographic findings (odds ratio 1.8, 95% CI 1-3 .3, P = 0.04) but not age, duration of disease, or clinical severity in a b inary logistic regression model. Autonomic disturbances are common (55%) in CTS, occurring with increasing severity of electrophysiologic findings. (C ) 2000 John Wiley & Sons, Inc.