[Bilateral idiopathic carpal tunnel syndrome in a child under 10 years of age]. / Síndrome del túnel carpiano idiopático bilateral en un niño menor de 10 años.

INTRODUCTION: The carpal tunnel syndrome is the most frequent compression neuropathy in the adult population, being very uncommon in children, particularly under the age of 10 years. The most frequent etiology is the lisosomal storage diseases, followed by anatomical disorders, trauma, intensive sports practice and some idiopathic cases among others. In this paper we are presenting a case of an idiopathic and bilateral carpal tunnel syndrome in a 9 years old boy. CASE REPORT: A 9 year-old patient suffering daily paresthaesias in both hands for a year, producing limitations in hand mobility which disappear after physical movement of the hands. He played basketball at school, he was right handed and had no history of systemic family illnesses. After the exploration, he scored 4/5 in left thumb abductor strength and no thenar muscle hypotrophy. He achieved the criteria of attention deficit and hyperactivity disorder. Electroneurography tests confirmed the diagnosis. The etiology study was normal after completed. After bilateral surgery, the patient achieved a complete recovery. CONCLUSIONS: The importance of this clinical case lies in its rare manifestation in children under the age of 10, being bilateral and not being included in the most frequent etiology group. It has a late diagnosis because it has an etiology and clinical manifestation different from adults. The diagnosis is being done through electroneurography. Open surgical release is almost ever the treatment.

Síndrome del túnel carpiano idiopático bilateral en un niño menor de 10 años / Bilateral idiopathic carpal tunnel syndrome in a child under 10 years of age

Introducción. El síndrome del túnel carpiano es la neuropatía por compresión más frecuente en el adulto. Sin embargo, es un cuadro raro en la edad pediátrica, sobre todo por debajo de los 10 años de edad. La etiología más frecuente son las enfermedades de depósito lisosomal, seguidas por las anomalías anatómicas, casos familiares, traumatismos, práctica intensiva de ciertos deportes y casos idiopáticos. Presentamos un caso de síndrome del túnel carpiano, bilateral e idiopático enun niño de 9 años. Caso clínico. Niño de 9 años que presentaba desde hacía un año parestesias diurnas en ambas manos, con dificultad en la manipulación y que desaparecían tras movilizarlas. Era un jugador de baloncesto escolar, diestro y sin enfermedadessistémicas familiares. Cumplía los criterios de trastorno por déficit de atención/hiperactividad. La exploración mostró una fuerza de 4/5 en el músculo abductor del pulgar izquierdo. No había hipotrofia de la musculatura tenar. La electroneurografíaconfirmó el diagnóstico de síndrome del túnel carpiano. Se completó el estudio etiológico, que resultó normal. Tras realizar la cirugía bilateral, el paciente presentó una mejoría sintomática completa. Conclusiones. La importancia de este caso clínico es la rareza de su presentación en niños menores de 10 años, sobre todo con afectación bilateral y sin pertenecer al grupo etiológico más frecuente. La etiología y la sintomatología clínica distintas a las del adulto condicionan que el diagnóstico sea tardío. El diagnóstico de confirmación se realiza por electroneurografía y el tratamiento es casi siempre quirúrgico

Introduction. The carpal tunnel syndrome is the most frequent compression neuropathy in the adult population,being very uncommon in children, particularly under the age of 10 years. The most frequent etiology is the lisosomal storage diseases, followed by anatomical disorders, trauma, intensive sports practice and some idiopathic cases among others. In this paper we are presenting a case of an idiopathic and bilateral carpal tunnel syndrome in a 9 years old boy. Case report. A 9 year-old patient suffering daily paresthaesias in both hands for a year, producing limitations in hand mobility which disappearafter physical movement of the hands. He played basketball at school, he was right handed and had no history of systemic family illnesses. After the exploration, he scored 4/5 in left thumb abductor strength and no thenar muscle hypotrophy. Heachieved the criteria of attention deficit and hyperactivity disorder. Electroneurography tests confirmed the diagnosis. The etiology study was normal after completed. After bilateral surgery, the patient achieved a complete recovery. Conclusions. The importance of this clinical case lies in its rare manifestation in children under the age of 10, being bilateral and not being included in the most frequent etiology group. It has a late diagnosis because it has an etiology and clinical manifestationdifferent from adults. The diagnosis is being done through electroneurography. Open surgical release is almost ever the treatment