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An unusual cause of carpal tunnel syndrome
  1. J Kowalewska-Zietek1,
  2. T P Dawson1,
  3. Dinesh Damodaran1,
  4. Julian D Gillmore2
  1. 1Lancashire Teaching Hospitals Foundation Trust, Preston, UK
  2. 2National Amyloidosis Centre, UCL Medical School, Royal Free Hospital, London, UK
  1. Correspondence to J Kowalewska-Zietek, Consultant Neurologist, Lancashire Teaching Hospital Trust, Sharoe Green Lane, Preston PR2 9HT, UK; Jolanta.Kowalewska-Zietek{at}lthtr.nhs.uk

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Carpal tunnel syndrome is one of the most common conditions encountered in general neurological practice, the usual cause being occupational activities using repeated wrist movement such as housework, typing or gardening. Under normal conditions, the carpal tunnel is already crowded with structures including nerves and tendons, with little extra space to accommodate expansion of its contents. Any increase in volume may have a significant impact on its clinically most sensitive structure, the median nerve.1 In most cases, symptoms arise simply from excessive use of the hand producing friction and swelling of the nerve. Additional pathological conditions affecting the carpal tunnel include diabetes mellitus, pregnancy, tumours, myeloma, myxoedema, acromegaly and pathological enlargement of joints or tendons such as in rheumatoid arthritis.2 3 However, we have recently encountered an unusual cause for this otherwise common clinical condition, which clinicians should be aware of during normal clinical practice.

Introduction

Tingling in the hands at night is most commonly related to carpal tunnel syndrome, one of the most common conditions encountered in general neurological practice. The carpal tunnel is already crowded with structures including nerves and tendons, with little extra space. Any increase in the volume of its contents may have a significant effect on the median nerve. Most cases of carpal tunnel syndrome are idiopathic, …

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