Carpal Tunnel Syndrome in Young Patients Caused by Anomalous Median Nerve and Aberrant Muscle: A Case Series.
Year: 2026
Type: article
Abstract: Introduction: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity, typically affecting middle-aged and elderly individuals. Occurrence in adolescents or young adults without identifiable systemic risk factors is uncommon and often indicates an underlying structural cause. Anatomical variations, such as anomalous muscle bellies or median nerve abnormalities can reduce the space within the carpal tunnel and lead to symptomatic nerve compression. Case Series: We present a series of four young patients aged 15-27 years who presented with symptoms suggestive of CTS without conventional risk factors. All patients demonstrated positive clinical provocative tests and electrophysiological evidence of median nerve compression. Imaging, where performed, suggested anatomical abnormalities within the carpal tunnel. Surgical exploration identified aberrant muscle bellies associated with median nerve compression; bifid median nerve and persistent median artery were also identified among the reported anatomical findings. All patients underwent open carpal tunnel release, with management of the aberrant muscle determined intraoperatively. Post-operative recovery was clinically favorable during the available short-term follow-up. Conclusion: Anatomical variations, such as aberrant muscle bellies and median nerve variants should be considered in young patients presenting with CTS symptoms, particularly when conventional risk factors are absent. In selected patients, imaging and careful intraoperative assessment may help identify structural contributors and guide individualized surgical management. Given the small case series and lack of a comparator, these observations should be considered hypothesis-generating rather than definitive.
Source: PubMed
Institution: All India Institute of Medical Sciences, Mangalagiri
Language: English
Topic: Peripheral Nerve Disorders
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225565974