The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome

Rheumatol Int. 2012 May;32(5):1285-90. doi: 10.1007/s00296-010-1772-z. Epub 2011 Jan 29.

Abstract

The aim of this study was to evaluate the efficacy of steroid injection for the treatment of the carpal tunnel syndrome (CTS), with F-wave parameters and sympathetic skin response (SSR). Seventeen hands of 10 women patients were treated with local steroid injection with 2-month follow-up. All patients underwent single injection into the carpal tunnel. Response to injection was measured nerve conduction studies (NCSs), median nerve F waves, and SSR before and after treatment. To determine the normal values, 42 hands of 21 healthy women were also studied. There was a significant improvement of sensory and motor nerve conduction values when compared to baseline values (P < 0.01). At the end of follow-up period, the median sensory distal latency and the sensory latency differences between the median and the ulnar nerve were improved 35 and 65%, respectively. The maximum, mean F-wave amplitudes and chronodispersion showed a slight improvement with respect to baseline values and controls, but statistical significance was not achieved after treatment. Although no statistically significant improvements were observed in SSR parameters, slightly decreased amplitudes and increased habituation of SSR were noted at the end of the treatment. The present study shows that the local steroid injection results in improvement in NCSs values, but the F-wave parameters were not effectual in short-term outcome of CTS treatment. These findings suggest that the sensory latency differences between the median and the ulnar wrist-to-digit 4 are better parameters in the median nerve recovery after treatment than the median sensory distal latency. Furthermore, the SSR does not seem to be a sensitive method in follow-up of CTS treatment.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / drug therapy*
  • Carpal Tunnel Syndrome / physiopathology
  • Case-Control Studies
  • Dexamethasone / administration & dosage
  • Dexamethasone / analogs & derivatives*
  • Electromyography
  • Female
  • Humans
  • Injections
  • Median Nerve / drug effects*
  • Median Nerve / physiopathology
  • Middle Aged
  • Motor Neurons / drug effects
  • Neural Conduction / drug effects*
  • Predictive Value of Tests
  • Prospective Studies
  • Reaction Time / drug effects
  • Sensory Receptor Cells / drug effects
  • Skin / innervation*
  • Sympathetic Nervous System / drug effects*
  • Sympathetic Nervous System / physiopathology
  • Time Factors
  • Treatment Outcome
  • Turkey
  • Wrist / innervation*

Substances

  • Adrenal Cortex Hormones
  • dexamethasone 21-phosphate
  • Dexamethasone