ANAMNESIS

1. Location, where do you feel it? how it is transmitted ?

2. Quality, What does it feel like?
3. Quantity or severity, how much pain is felt (if pain asks to give a
scale of 1-10)
4. Time, when started? how long does the complaint last? how often
does it appear?
5. circumstances that trigger a complaint, including environmental
factors, personal activity, emotional reactions, or other
circumstances related to disease complaints
6. Other factors that relieve and aggravate the symptoms, Is there
anything else that eases or aggravates complaints?
7. Other symptoms that accompany the main complaint, do you feel
any other complaints that accompany

physical examination

Examination should be done thorough examination in patients with special attention to function,
motor, sensory and autonomous hand. Some checks and provocation tests can help diagnose :

Tinnels Test
on examination of the median nerve, with emphasis on the
transverse carpi ligament (volare). Tinnel's test (+) if it arises netri
means there is nerve clamping

Phalent s Test
on examination of the traps of the median nerve, hyperflexing the
wrist by matching both the backs of the hands

Sensibility Test
namely the examination of the sensibility of the region supplied
by the median nerve nerve, the radial nerve. and ulnar nevus. the
lack of sensitivity to the examination (can by pressing using sharp
/ dull objects) leads us to the trap of which nerve experienced
Supporting
investigation
 Neurophysiology examination (electrodiagnostic)

The EMG examination may indicate the presence of fibrillation, polyphic, positive waves and
reduced number of motor units on the thenar muscles. In some cases there are no abnormalities in
the lumbrical muscles. EMG can normal in 31% of CTS cases. Nerve Conductivity Speed (KHS). At 15-
25% case, KHS can be normal. On the other KHS will decrease and latency period distal (distal
latency) extends, indicating a conduction disturbance nerves on the wrist. Sensory latent is more
sensitive than latent period motor.

Radiological Examination

An X-ray examination of the wrist may be helpful see if there are other causes such as fractures or
arthritis. Plain neck photo useful to exclude other diseases of the vertebra. Ultrasound, CT-scan and
MRI is performed in a particularly selective case that will be operated on. Ultrasound performed to
measure the cross-sectional area of the median nerve in the carpal tunnel proximally sensitive and
specific to carpal tunnel syndrome.

Laboratory examination

If the etiology of CTS is not clear, for example in young people without the presence of repetitive
hand movements, can be done some examination such as blood sugar levels, thyroid hormone levels
or complete blood.

Fuller, Graint.2008.Practical checkpoint Neurologis.Jakarta, medical of books, EGC