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CTS in CMT

Robert Wallach4/12/23 10:22 AM (CDT)

I have a referral on a 61-year-old female with a stated history of Charcot-Marie-Tooth (type not specified) with progressive symptoms and loss of function, ambulation, etc. Clinical question regarding possibility of carpal tunnel given hand intrinsic atrophy and numbness median distribution right greater than left. I have not seen the patient yet. I am just thinking about how one might be able to tell if there is carpal tunnel on top of Charcot-Marie-Tooth? I have only seen a couple of patients with inherited demyelinating neuropathies in my 20-year career but my understanding is that I should expect significantly prolonged distal latency, very slow conduction velocities, probably absent sensory responses and probably chronic denervation on needle EMG. Does anybody have a take on how I might determine electrodiagnostically if there is also carpal tunnel? My assumption is the clinical symptoms might be revealing as well so I will be interested to hear what the patient says from that standpoint.

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I enjoy participating in the AANEM Connect Forum for a number of reasons. There are very fundamental questions posed on a frequent basis that cause me to pause and ask myself, ‘Why didn’t I think of that?’ Also, I continue to learn new things when others contribute their thoughts and experiences. Connect is an excellent opportunity for members to interact and to address any topic, including those that may not be discussed at an annual meeting or journal article.
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