Carpal tunnel syndrome in infancy. Concerning a case of early onset
Introduction. The carpal tunnel syndrome (CTS) is the commonest neuropathy due to compression to be seen in adults. There are very few cases in the literature referring to patients of paediatric age, particularly those under ten years old. Most of these young patients had a metabolic disorder (mucopolysaccharidosis (MPS) or mucolipidosis (ML)). In fact, as many as 90% of the MPS had CTS, sometimes subclinically. This syndrome is caused by compression of the median nerve at the level of the carpal tunnel, to which multiple factors may contribute, both local and systemic, as reviewed in this paper. The clinical findings differ from those in adults, but the appearance of suggestive symptoms and signs should make one suspect the condition and request an electromyographic study (EMG) which would be diagnostic. Clinical case. We describe the case of a five year old girl, with a clinical history suggesting the presence of a carpal tunnel syndrome for 12 months and characterized by paraesthesia and limitation of flexon-extension movements of the fingers of the affected hand, with pain on movement. The symptoms appeared on waking in the morning, gradually improved as the day advanced and became bilateral over a period of six months. The diagnosis was confirmed by EMG and MR helped to clarify the aetiology. Conclusion. The interesting aspect of this article is the youth of the patient, the absence of known etiological factors and the presence of tenosynovitis detected on MR as has been described in some idiopathic/familial forms
Caso clínico Se describe el caso de una niña de 5 años, con clínica sugestiva de doce meses de evolución, caracterizada por parestesias y dificultad para la flexoextensión de los dedos de la mano, con dolor a la movilización. La sintomatología se aprecia al despertar del sueño nocturno y remite de forma progresiva a lo largo de la mañana, además, se hace bilateral en el transcurso de seis meses. La EMG confirmó el diagnóstico y la RM ayudó a aclarar la etiología.
Conclusión El interés de esta publicación estriba en la corta edad de la paciente, la ausencia de etiología conocida y la existencia de una tenosinovitis detectada mediante RM, que coincide con lo descrito para algunas formas idiopáticas/familiares
