Abstract Body

CASE REPORT: IT'S NOT ALL ABOUT CARPAL TUNNEL SYNDROME

1. Background:

The carpal tunnel syndrome is a common medical consultation. However, a clinical-diagnose test dissociation or a non responding to treatment should make the physician to reconsider the diagnose and go beyond a simple carpal tunnel syndrome.

2. Methods:

We report the case of a 53 year-old man , hairdresser occupation, who related five month of numbness and tingling on left hand and fingers. The paresthesias didn't get better with gabapentin and non-steroidal anti-inflammatories.

The electromyography showed radicular C6 radiculopathy with a slight recruitment deficit and a minor carpal tunnel syndrome.

Magnetic resonance imaging - cranial : hyperintense lesions with microvascular appearence in white matter. Other demyelinating lesions in both hemispheres, periventricular, corpus callosum, centrum semiovale, union bulge pons, medulla oblongata, right hemimidbrain, right cerebellar mespeduncle.

Magnetic resonance imaging - cervical: Demyelinating lesions at medulla oblongata, posterior cords C3, C4, C6 and C7. Vertebral disc prolapse C6-C7 with a reduction of the cervical canal and right spinal radiculopathy.

3. Results:

The patient is refered to Neurology department to study a Multiple Sclerosis.

4. Conclusions:

Although Carpal tunnel syndrome is a very typical lesion in Primary Care, clinicians need to be aware and make a differential diagnose when the patient do not respond correct to treatment .