cidp vs carpal tunnel

When I was first going through all the tests after being diagnosed, one of the things on my chart was carpel tunnel. I definitely hadn’t had it before and do not do any repetitive work that would have created it. It showed up after having an EMG. I just assumed it was nerve damage associated with the GBS, but never brought it up with the neurologist.

I’ll bet you hear from others who have carpel tunnel since GBS/CIDP.

[QUOTE=ConnorZmom]How will we know the difference ? Has anyone had true carpal tunnel AND cidp ?

I’m having some probs with my right hand…which, the right side has been the “better” side…not so much now, I guess.

have a good day everyone.

Stacey[/QUOTE]
Hi Stacey,
I think that you have asked an excellent question. My husband who is now diagnosed with CIDP MADSAM had carpal tunnel diagnosis in the beginning and had surgery back in 2003. His hand function continued to deteriorate after the surgery. When he was referred to a second neurologist, the comment was he could have had carpal tunnel and then CIDP. But it is interesting to note that several months later when the neurologist who said this was talking to another specialist who examined him, the neurologist commented something to the effect “he was misdiagnosed with carpal tunnel”. My cynical perspective is that doctor’s often cannot differentiate what is causing the symptoms and there are needless surgeries done. We speculated that my husband’s second neurologist was attempting to cover the butt of the first neurologist with the comments that he could have had carpal tunnel and then developed CIDP–as the later comments seemed to indicate that it was misdiagnosed.

I too would like to know how a doctor could know if it is carpal tunnel when the person has CIDP. I suspect the person would have to have an exploratory surgery to see if there was a visible impingement happening. But I think those impingements are so microscopic that it would take a real expert surgeon to know the difference. When we were trying to get to the bottom of what was going on with my husband, we did go to a specialist who within five minutes of examination and history taking did say “you never had carpal tunnel syndrome”. He based this on history and examination. He was the top hand surgeon in our area and he then referred hubby to neuromuscular disease unit. Yet the first neurologist diagnosed carpal tunnel and the surgeon operated and said he freed up impingements. So how does one have faith? I think going for a second or third opinion is necessary before you have any surgery done.
Laurel

Stacey,
I wonder if all the repetitive work exacerbates your CIDP? I know that my husband, who has CIDP and atrophy in the right hand(permanent) but he has improved dramatically with IVIG in the sense of increased grip and strength. He can have episodes of decreased strength if he over uses it. We have horses and he trims their feet. If he trims four feet in a day, he notices decreased strength and sometimes spasm. But if he limits it to trimming two feet, he doesn’t have a set back. So basically my question is “does your repetitive work cause an exacerbation of CIDP symptoms?” And then I guess I have a second question which is “how could the neurologist determine whether it is a CIDP flare up versus carpal tunnel symptoms?”.
Laurel

I don’t have carpal tunnel, but I did end up having surgery to free a nerve impingement in my peroneal nerve. There was definately scar tissue and once the nerve was freed we thought all would be well. However, it was after the surgery on my peroneal nerve that the numbness started spreading thus leading to a diagnosis of CIDP. I have always wondered if the surgery on the nerve (actually the second surgery on a nerve I’d had in less than a year) I’ve always wondered if it contributed to and/or caused the CIDP. Like my autoimmune system was ripe to misfire and the surgery on or near the nerves gave it a target. Just a thought, no idea if it holds weight or not. I wouldn’t be too hard on your neurologist though as one of the criteria for CIDP is that it affects more than one nerve so an initial diagnosis of carpal tunnel might have been on target at that point but when it spread that led to the diagnosis of CIDP. :confused:

I am affected with residuals of GBS so can’t answer your first question Stacey, about CIDP and carpal tunnel but when I saw my neurologist in Nov. he did an EMG and NCV. The tests indicated carpal tunnel when he did my arms/wrists but then he did my legs and immediately said it was a polyneuropathy. He suggested I wouldn’t need any surgery if I did some exercises etc. I too, don’t do any repetitive hand movements so don’t see how I could get it. That seemed to be the final report as well so I have not had it treated in any way. The doctors I have seen are feeling that it is probably not carpal tunnel but rather related to the residuals. I have seen other threads on the forum about this so you may want to do a search and see what others have said.

[QUOTE=Julie]I don’t have carpal tunnel, but I did end up having surgery to free a nerve impingement in my peroneal nerve. There was definately scar tissue and once the nerve was freed we thought all would be well. However, it was after the surgery on my peroneal nerve that the numbness started spreading thus leading to a diagnosis of CIDP. I have always wondered if the surgery on the nerve (actually the second surgery on a nerve I’d had in less than a year) I’ve always wondered if it contributed to and/or caused the CIDP. Like my autoimmune system was ripe to misfire and the surgery on or near the nerves gave it a target. Just a thought, no idea if it holds weight or not. I wouldn’t be too hard on your neurologist though as one of the criteria for CIDP is that it affects more than one nerve so an initial diagnosis of carpal tunnel might have been on target at that point but when it spread that led to the diagnosis of CIDP. :confused:[/QUOTE]
Hi Julie,
Your comments are interesting as my husband wondered if the carpal tunnel surgery triggered things for him too. He went from minor problems to major problems after the surgery. I feel disappointed and I guess critical of the first neurologist because he didn’t test all four limbs in my husband when he made the diagnosis of carpal tunnel which lead to the failed surgery. Once hubby was referred to the neuromuscular neurologist, he was tested in all limbs and deficits were found in all four. I wonder how common it is for neurologists just to do the EMG and nerve conduction studies on one limb only? Seems to me that testing all limbs would be the safest and most reliable way to proceed in diagnosing. It’s hard for me not to be negative about the first neurologist as the damage resulting is so significant and life changing. Generally I am an optimist, but I feel very outraged over what happened to my husband. It seems that you can’t go into any doctor’s office for any serious disease or illness without doing your own research first so that you know what should be looked at.
Laurel

Hi Stacey this might help you.

“Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.”

So that means in the nerve test it shows the little finger is ok then you would know your answer. My DR did asked me if I was ever diagnosed with carpal tunnel I told her no because she told me before that all my finger were affect and the carpal tunnel does not affect the baby finger.

Sue

[QUOTE=suewatters1]Hi Stacey this might help you.

“Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.”

So that means in the nerve test it shows the little finger is ok then you would know your answer. My DR did asked me if I was ever diagnosed with carpal tunnel I told her no because she told me before that all my finger were affect and the carpal tunnel does not affect the baby finger.

Sue[/QUOTE]
Interesting Sue. I just asked my husband if he his little finger was affected before he had his carpal tunnel surgery, and he said that it was as he couldn’t move it. Another bit of info. that makes one know how informed we have to be before embarking on surgery. It speaks again to second and third opinions. I would guess that when the specialist surgeon said that my husband never had carpal tunnel after a five minute interview and exam (two years after the carpal tunnel surgery), it may have been partially based on that little finger question. I know that he seemed quite perplexed that hubby had ever been referred for surgery.
Laurel