1. Pain and tingling in hands at night
2. Weakness of thumb abduction
3. Loss of sensation over lateral half of the palm
4. Atrophy of hypothenar eminence
Select the correct answer using the code given below :
Carpal Tunnel Syndrome: Clinical Features
Carpal Tunnel Syndrome (CTS) is caused by compression of the median nerve as it passes through the carpal tunnel at the wrist. Its clinical features reflect the sensory and motor territory supplied by the median nerve distal to the wrist.
Analysis of Each Statement
- Statement 1: Pain and tingling in hands at night — Correct. Nocturnal exacerbation of pain and paraesthesia is one of the most classic and characteristic symptoms of CTS, typically worsened by wrist flexion during sleep and relieved by shaking the hand ("flick sign").
- Statement 2: Weakness of thumb abduction — Correct. The median nerve innervates the abductor pollicis brevis (part of the thenar/LOAF muscle group). Compression in the carpal tunnel therefore produces weakness of palmar thumb abduction, a key motor sign used clinically to assess median nerve involvement.
- Statement 3: Loss of sensation over lateral half of the palm — Correct. The median nerve supplies sensation to the palmar aspect of the thumb, index, middle, and radial half of the ring finger, along with the adjoining radial (lateral) part of the palm via its palmar cutaneous branch. Sensory loss in CTS is therefore typically described over this lateral half of the palm.
- Statement 4: Atrophy of hypothenar eminence — Incorrect. The hypothenar muscles are supplied by the ulnar nerve, not the median nerve. Atrophy of the hypothenar eminence is a feature of ulnar nerve pathology, not CTS. In CTS, it is the thenar eminence (median-nerve-supplied) that undergoes atrophy in longstanding or severe cases — not the hypothenar eminence.
Conclusion
Statements 1, 2, and 3 correctly describe features of Carpal Tunnel Syndrome, while statement 4 incorrectly attributes an ulnar-nerve-related sign (hypothenar atrophy) to a median nerve disorder. Hence, the correct answer is the option combining 1, 2 and 3.
Important Questions from Neuropathies
Consider the following clinical features :
1. Hypomimia
2. Dysphonia
3. Festination gait
4. Cogwheel rigidity
Which of the features given above are generally present in Parkinsonism?
- Circuits between the basal ganglia and the motor cortex constitute the extra pyramidal system which controls muscle tone, body posture and the initiation of movement. Lesions of the extra pyramidal system present clinically with :
Consider the following statements regarding Transient Global Amnesia (TGA):
1. TGA mainly affects middle aged persons who present with abrupt, discrete loss of anterograde memory lasting for few hours.
2. During the episode, the patients are unable to record new memories resulting in repetitive questioning.
3. Consciousness is impaired during the episode and the patient is unable to perform even simple motor functions.
4. After 4-6 hours, memory function and behaviour return to normal but the patient has complete and persistent amnesia for the duration of the episode.
Which of the statements given above are correct?
- Which of the following correctly describes the primary position of the right eye in right 3rd cranial nerve palsy?
- Which one of the following distinguishes axonal degeneration from segmental demyelination on electrophysiological studies?
