ABSTRACT
Background: few reports represent palmar cutaneous nerve neuropathy in the wrist due to a ganglion cyst
Case Presentation: a 25-year-old female was presented with a mass at volar side of the wrist and hypoesthesia at the base of thenar eminence. At ulrasonographic examination, a simple cyst was detected. Sensory response of palmar cutaneous branch of median nerve was absent at the affected side
Treatment: ultrasound guided drainage of the cyst was performed. At 3 months follow up examination, the patient was symptom-free
Learned Lessons: this case was rare among cases involving pal mar cutaneous branch of median nerve due to the wrist ganglion documented by Nerve Conduction Studies [NCS]
ABSTRACT
To study the effects of Polarized Polychromatic Noncoherent Light [Bioptron] therapy on patients with carpal tunnel syndrome [CTS]. This study was designed as a randomized clinical trial. Forty four patients with mild or moderate CTS [confirmed by clinical and electrodiagnostic studies] were assigned randomly into two groups [intervention and control goups]. At the beginning of the study, both groups received wrist splinting for 8 weeks. Bioptron light was applied for the intervention group [eight sessions, for 3/weeks]. Bioptron was applied perpendicularly to the wrist from a 10 centimeters distance. Pain severity and electrodiagnostic measurements were compared from before to 8 weeks after initiating each treatment. Eight weeks after starting the treatments, the mean of pain severity based on Visual Analogue Scale [VAS] scores decreased significantly in both groups. Median Sensory Nerve Action Potential [SNAP] latency decreased significantly in both groups. However, other electrophysiological findings [median Compound Motor Action Potential [CMAP] latency and amplitude, also SNAP amplitude] did not change after the therapy in both groups. There was no meaningful difference between two groups regarding the changes in the pain severity. Bioptron with the above mentioned parameters led to therapeutic effects equal to splinting alone in patients with carpal tunnel syndrome. However, applying Bioptron with different therapeutic protocols and light parameters other than used in this study, perhaps longer duration of therapy and long term assessment may reveal different results favoring Bioptron therapy
ABSTRACT
Carpal Tunnel Syndrome [CTS] is the most common type of entrapment neuropathy. Conservative therapy is usually considered as the first step in the management of CTS. Low Level Laser Therapy [LLLT] is among the new physical modalities, which has shown therapeutic effects in CTS. The aim of the present study was to compare the effects of applying LASER and splinting together with splinting alone in patients with CTS. Fifty patients with mild and moderate CTS who met inclusion criteria were included in this study. The disease was confirmed by electrodiagnostic study [EDx] and clinical findings. Patients were randomly divided into 3 groups. Group A received LLLT and splinting. Group B received sham LLLT+ splinting and group C received only splints. Group A received LLLT [50 mw and 880nm with total dose of 6 joule/cm[2]]. Clinical and EDx parameters were evaluated before and after treatment [3 weeks and 2 months later]. Electrophysiologic parameters and clinical findings including CTS provocative tests, Symptoms severity score [SSS], Functional Severity Score [FSS] and Visual Analogue Score [VAS] were improved in all three groups at 3 weeks and 2 months after treatment. No significant changes were noticed between the three groups regarding clinical and EDX parameters. We found no superiority in applying Low Intensity Laser accompanying splinting to traditional treatment which means splinting alone in patients with CTS. However, future studies investigating LLLT with parameters other than the one used in this study may reveal different results in favor of LLLT.