Double crush syndrome Discussion

Double crush syndrome refers to a situation in which there is compression or local irritation of a peripheral nerve at several separate sites along its course. An example of this is coexistent C6 radiculopathy (neck site) and carpal tunnel syndrome (wrist site). There are several implications of double crush syndrome:

- The relative contribution at each site may be difficult to assess, and make surgical priorities unclear.

- The patient may have signs and symptoms out of proportion to findings documented by electrical nerve testing.

- Correction of the problem at one site alone is more likely to result in lingering or persistent symptoms.

- The patient may have an underlying constitutional tendency toward irritative nerve symptoms.

The existence of double crush syndrome is controversial, but I believe that it is a clinically significant consideration which makes the results of treatment less predictable.

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