LYCOS RETRIEVER 
Carpal Tunnel Syndrome: Nerves
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One study has reported a higher risk for carpal tunnel in people with a family history of the problem, indicating that a genetic susceptibility exists in some people. Some researchers are particularly interested in abnormalities in certain genes that regulate myelin, a fatty substance that serves as insulation for nerve fibers. Some people may be born with abnormalities of the carpal bones.
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Often, an electromyogram, which includes nerve conduction studies, is done to document the extent of nerve damage in carpal tunnel syndrome. An electromyogram is a test that measures the electrical activity in your nerves and muscles. Nerve conduction studies measure the ability of specific nerves to transmit electrical impulses or messages.
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General symptoms are similar to carpal tunnel syndrome, but patients experience loss of sensation in the ring and little finger and in the outer half of the palm. It can be a separate problem, although it commonly occurs with CTS. In such cases, release surgery for CTS usually ... relieves the ulnar nerve entrapment.
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Carpal tunnel release surgery should be considered in patients with symptoms that do not respond to conservative measures and in patients with severe nerve entrapment as evidenced by nerve conduction studies, thenar atrophy, or motor weakness. It is important to note that surgery may be effective even if a patient has normal nerve conduction studies.30,31
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Ifa carpal tunnel release is performed after significant denervation has led to atrophy of the thumb muscles, the surgery will not improve the loss of muscle strength. Once the muscle is denervated, it is impossible for the nerve to form a new connection to the muscle. While sensation in the hand can sometimes improve following surgery, muscle strength and motor function do not. However, recurrence of CTS symptoms after surgery is rare.
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Kuntzer T. Carpal tunnel syndrome in 100 patients: sensitivity, specificity of multi-neurophysiological procedures and estimation of axonal loss of motor, sensory and sympathetic median nerve fibers. J Neurol Sci 1994 Dec 20; 127(2): 221-9.
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