KB Tam, KY Chan, S Fong, EKC Yau

Abstract

Carpal tunnel syndrome (CTS) is rare in children. Lysosomal storage diseases including mucopolysaccharidosis and mucolipidosis, account for most of the underlying causes of childhood onset CTS. Rare causes such as trauma, aberrant ligaments, and muscle slings in the carpal tunnel and sports-related CTS have also been reported in children. Classical CTS occurs due to compression of the median nerve in the wrist when it runs through the carpal tunnel and usually presents with early sensory and late motor symptoms related to the territory of median nerve. Children with CTS however often have very few complaints despite long standing difficulty in manual tasks. Most of them are diagnosed late in the course of nerve compression with severe thenar weakness and atrophy. We describe the clinical features, hand function assessment, MRI findings and surgical outcome in a 12 years old girl with thenar muscles atrophy due to bilateral carpal tunnel syndrome with entrapment of the recurrent motor branches of median nerves.