Publication: Relationship between electrodiagnostic severity and neuropathic pain assessed by the LANSS pain scale in carpal tunnel syndrome.
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KOLUKISA, MEHMET
Gürsoy, AZİZE ESRA
YıLDıZ, GB
KOCAMAN, G
CELEBI, A
KOÇER, A
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Abstract
Objective: The aim of the study was to investigate the relationship between the presence of
neuropathic pain assessed by the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)
scale and electrophysiological findings in patients with carpal tunnel syndrome (CTS).
Methods: We studied 124 hands with idiopathic CTS with pain complaints involving hand and
wrist. All hands were assessed by the LANSS with which a score of 12 or more is defined as pain
dominated by neuropathic mechanisms. These hands were assigned to minimal, mild, moderate,
severe, or extreme severe groups according to the results of the median nerve conduction studies.
Results: A LANSS score $ 12, suggestive of pain dominated by neuropathic mechanisms, was
defined in 59 (47.6%) CTS hands. Pain intensity was significantly higher in CTS hands with
a LANSS score $ 12 (P , 0.001). Among electrophysiological findings, compound muscle
action potential amplitude was significantly lower in hands with a LANSS score $ 12 compared
with hands with a LANSS score , 12 (P = 0.020). Severity of CTS was not significantly
different between LANSS $ 12 and LANSS , 12 groups. Electrophysiological severity was
significantly higher in CTS hands with evoked pain (P = 0.005) and allodynia (P , 0.001) in
LANSS subscore analysis.
Conclusion: We suggest that the presence of pain dominated by neuropathic mechanisms in CTS
is not related to electrophysiological CTS severity. Neuropathic pain should be assessed carefully
in patients with CTS, and an appropriate treatment plan should be chosen, taking into account
the clinical and electrophysiological findings together with the true pain classification.
Keywords: electrodiagnostic evaluation, carpal tunnel syndrome, LANSS, neuropathic pain
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Gürsoy A. E. , KOLUKıSA M., YıLDıZ G., KOCAMAN G., CELEBI A., KOÇER A., -Relationship between electrodiagnostic severity and neuropathic pain assessed by the LANSS pain scale in carpal tunnel syndrome.-, Neuropsychiatric disease and treatment, cilt.9, ss.65-71, 2013