Case history
Case history
A 50-year-old woman presents with numbness and tingling in her hands. The symptoms are worse in her right (dominant) hand and with activities such as holding a book or a steering wheel, or brushing her hair. The discomfort in her hands frequently wakes her at night and she has to shake or hang her hand out of her bed for relief.
Other presentations
Pain or aching usually on the anterior aspect of the wrist (commonly in the region of the distal wrist crease), worse after activity or during the night. Aching often extends from the wrist to the forearm in many patients and to the upper arm in some. Clumsiness, loss of hand dexterity, and complaints of dropping things may be presenting features, mostly due to loss of afferent feedback from key functional fingers (first to third fingers in particular). There may be evidence of weakness and wasting in the hand, particularly over the thenar eminence.
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