Working Hand Syndrome: A New Definition of Nonclassified Polyneuropathy Condition

Abstract

The aim of this chapter was to define an unexplained nonclassified polyneuropathy condition as a new neurological disease. This new diagnosis of occupation-related polyneuropathy has been named as “working hand syndrome (WHS).” This study collected and compared clinical and electrophysiological analyses data from healthy controls, WHS patients, carpal tunnel syndrome (CTS) patients, and polyneuropathy patients. The WHS patients presented to the clinic with pain, numbness, tingling, and burning sensations in their hands that increased significantly during rest and nighttime. However, there was no weakness in the muscles, and the deep tendon reflexes were normal in this disease. The patients had all been working in physically demanding jobs requiring the use of their hands/arms for at least 1 year, but no vibrating tools were used by the patients. All of the cases were men. I suppose that overload caused by an action repeated chronically by the hand/arm may impair the sensory nerves in mentioned hand/arm. In patients with these complaints, for a definitive diagnosis, similar diseases must be excluded. Nonetheless, the specific electrophysiological finding that the sural nerves are normal on the lower sides, as well as the occurrence of sensory axonal polyneuropathy in the sensory nerves without a significant effect on velocity and latency in the work-ups of the upper extremity are enough to make a diagnosis.