الفهرس 
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Abstract
Carpal tunnel syndrome is the most common entrapment neuropathy with a constellation of symptoms associated with compression of the median nerve at the wrist. Carpal tunnel syndrome has a lifetime risk of 10% and annual risk of 0.1% with women more affected than men with a ratio of 3:1. The mean ages ranges from 45 to 60 years, only 10% of reported cases of carpal tunnel syndrome are younger than 30 years.
Diagnosis of carpal tunnel syndrome is based on the clinical and electrophysiological evaluations. Based on the electrophysiological findings carpal tunnel syndrome patients were classified into 6 grades from very mild carpal tunnel syndrome to extremely severe carpal tunnel syndrome. Electrophysiological studies conducted to patients with carpal tunnel syndrome revealed abnormalities in forearm segment of median nerve which is proximal to the site of compression. Many authors tried to explain these findings which indicate retrograde degeneration and whether this retrograde degeneration is related to the grades of severity of carpal tunnel syndrome or not.
In the current work, median motor forearm amplitude, median motor forearm nerve conduction velocity, median mixed forearm amplitude and median mixed forearm nerve conduction velocity were used as parameters of retrograde degeneration.
The aim of this work was to study retrograde degeneration of median nerve forearm segment in carpal tunnel syndrome of variable severity in Egyptian patients.
This work was carried out on 30 hands of patients diagnosed as idiopathic carpal tunnel syndrome based on American Association of Electrodiagnostic Medicine (2002) where history taking and clinical examination were performed to confirm the diagnosis and to exclude secondary causes of carpal tunnel syndrome. Patients were randomly recruited from those attending the outpatient clinics of the Physical Medicine Rheumatology and Rehabilitation Department at the Main and El Hadara University Hospitals. A control group of twenty volunteers of matched age, sex and general constitutional status was enrolled in this work.
Electrophysiological studies conducted to carpal tunnel syndrome patients in the current work were the sensory and motor conduction study of the median, ulnar and superficial radial nerves as well as the forearm median mixed nerve conduction study and F wave latencies of the median and ulnar nerves.
According to the electrophysiological data there were two hands of carpal tunnel syndrome patients (6.66%) classified as grade 1, while there were six hands of carpal tunnel syndrome patients (20%) classified as grade 2. There were sixteen hands of carpal tunnel syndrome patients (53.33%) categorized as grade 3 and six hands of carpal tunnel syndrome patients (20%) categorized as grade 5.