1. Danta, G. “Familial carpal tunnel syndrome with onset in childhood.” J Neurol, Neurosurg, and Pysch, 1975; 38:350-355.
Suggests a specific pattern of CTS presentation in a large family tree with multiple members diagnosed with CTS.
2. Gossett, J.G., Chance, P.F., “Is there a familiar carpal tunnel syndrome? An evaluation and literature review.” Muscle & Nerve, 1998; 21: 1533-1536.
They reviewed the reports of families proposed to have the familial carpal tunnel syndrome (FCTS). The demographic features of sporadic carpal tunnel syndrome (CTS) differ from FCTS, where an earlier onset and increased bilateral involvement is seen. They also identify seven new potential FCTS pedigrees on the basis of their having four or more members with symptoms suggesting CTS. In all but two pedigrees an explanation other than FCTS was found. They conclude that the FCTS is a rare, but genetically distinct disorder.
In discussing FCTS, they indicate that some pedigrees in the literature suggest that 96% of those affected had bilateral involvement. In general, we see the clinical presentation of the problem on a bilateral basis in at least 70% of the patients. Their observation might not reveal a significant difference in the bilaterality if both sides are studied and the patients are followed long enough. Since the literature very strongly suggests that CTS is based on genetic predisposition with a narrowed carpal tunnel, which is present symmetrically in the wrist, it leaves one to wonder if, in fact, familial CTS is not almost the rule rather than the exception. This is up for further study.
3. Radecki, P., “The familial occurrence of carpal tunnel syndrome.” Muscle & Nerve, 1994; 17:325-330.
A prospective study was undertaken to determine the prevalence and significance of a positive family history of CTS. 75 of 253 women and 40 of 168 men with a confirmed diagnosis of CTS indicating that at least one relative had symptoms of or surgery for CTS. They determined that obtaining a positive family history for CTS was predictive of a median abnormality or prior surgery at the carpal tunnel. Of the 84 patients who had undergone carpal tunnel surgery, those who were felt to be the most well informed historically had a positive family history in 39%, compared with 13.3% of the 279 patients who did not demonstrate median latency slowing. Thus Dr. Radecki concluded that familial occurrence appears crucial in the epidemiological study of carpal tunnel syndrome and may be important in the selection of normal subjects for electrodiagnostic standards. He is suggesting that we must make certain that we are setting our standards correctly by not including those who are developing CTS in studying the values.
4. Stoll, C., Maitrot, D., “Autosomal dominant carpal tunnel syndrome.” Clin Genet, 1998; 54: 345-348.
A family very strongly riddled with members having CTS in three generations, plus some cousins was cited. Must Read.
5. Vallat, J.M., Dunoyer, J. “Familial occurrence of entrapment neuropathies.” Letters to the Editor, Acta Neurol, 1979; 36:323.