Idiopathic Bilateral Carpal Tunnel Syndrome in a Young Female: Early Diagnosis and Successful Surgical Outcome - A Case Report

Abstract

Background: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by median nerve compression within the restricted carpal tunnel, producing characteristic sensory and motor deficits in the hand. While often linked to repetitive wrist strain, endocrine disorders, or inflammatory conditions, idiopathic CTS in young individuals without systemic comorbidities may be under-recognized. Timely identification of the condition is crucial to avoid irreversible nerve injury and maintain optimal hand function.

Case Presentation: A 32-year-old woman presented with chronic right-hand pain, tingling, and nocturnal numbness without any history of trauma, systemic disease, or repetitive occupational activities. Physical examination demonstrated positive Tinel’s and Phalen’s signs. Nerve conduction studies revealed bilateral median nerve compression, more pronounced on the right. The patient underwent right-sided surgical decompression through an open carpal tunnel release. Postoperative recovery was uneventful, with significant improvement in sensory symptoms and hand function. She was discharged with instructions on wrist care, ergonomic modifications and follow-up electrophysiological assessment.

Conclusion: Idiopathic CTS can present subtly in otherwise healthy young adults and may easily be overlooked without thorough clinical and electrophysiological evaluation. Early identification, combined with timely surgical decompression when indicated, is crucial for optimal recovery and prevention of irreversible neuropathy. Comprehensive postoperative guidance further enhances long-term functional outcomes.