Carpal Tunnel Release or Ulnar Transposition for CIDP?

March 5, 2011 at 10:45 am

This question will surely make a great who dunnit mystery.

Meaning? Start with some symptoms- tingling, burning and numbness. Go to the doc. doc sends you to a neuro. Neruo, or somebody (a non-specialist) performs EMG/NCV testing and declares- Eureka! I’ve found it. You have slowing or other evidence of nerve problems across your wrist(s) and maybe your elbows. I recommend Carpal Tunnel Release.

Get the release done. At first, weeks and then months go by with no relief, no change in your symptoms. You may even get worse. I did. Oh, sigh. Oh, gee the surgery was not successful. Repeat the above.

Get a release done again. Ditto.

As for the elbow pain, they often perform an ulnar transposition. They make a small incision on the underside inside of your elbow and move the nerve away from the bony protuberance that is pinching it. It is often successful for those with a pinching problem.

Oh, yeah, I forgot- a carpal tunnel release, in theory, does the same thing. It relieves pressure from the ‘pinching’ of the median nerve where it passes through the tunnel.

Unfortunately, if your symptoms are due to the demyelination of the nerves caused by CIDP, then, in all likelihood, all your surgeries will be in vain. And, theoretically, could make your symptoms worse.

You see, I’ve been there, done that. I had the scope version of Carpal tunnel release (CTR) in- wait a second, I’ll look it up, Sept 2000. Then, I had an open release in 2002 and, ready for this? Scheduled for a third release in 2004, which was canceled the day before by a neurologist who finally said ‘hey, wait a second, maybe something else is going on….’

It was this neurologist, also not a specialist, who speculated ‘…patient may benefit from bilateral ulnar transpositions.’ Yeah, and maybe not.

Proceed at your own risk.