Stroke patients who've lost the use of one arm may be
handed another problem — carpal tunnel syndrome (CTS).
The condition commonly sets in when patients compensate
for the loss of function in one arm by overusing the unaffected
arm. Typical CTS treatments like NSAIDs, systemic corticosteroids,
diuretics or pyridoxine may have side effects in the relatively
elderly stroke population. An alternative treatment may
be the vitamin B12
analogue mecobalamin. According to a report in the April
15 issue of the Journal of Neurological Sciences
"[Mecobalamin] is a safe, noninvasive and potentially
efficacious therapy for CTS in patients following stroke."
While stroke patients may be more
concerned with the paralyzed limb, Dr Yoshihiro Sato's
team from Tagawa, Japan's Mitate Hospital previously
showed that sensory and motor conduction indices were
more altered in the unaffected arm than on the paretic
side. The researchers set out to discover if mecobalamin
could help prevent the onset of subclinical CTS.
Right-handed folks aged 65 and
older with unilateral hemiplegia/paresis subsequent
to strokes two to three years previously were enrolled
in the study. Of the 135 subjects, 67 were randomized
to take 1500mg of mecobalamin daily while 68 didn't
receive the supplement at all. Eleven patients were
excluded due to accompanying conditions that could mimic
CTS, systemic diseases known to cause CTS, or because
they'd been treated with vitamin B1,
B2, or B12,
or steroid hormones before or during the study period.
A control group included 55 age- and sex-matched right-handed
volunteers with no conditions affecting peripheral nerve
evaluation.
NEURO
SIGNS IMPROVED
As it turned out, the mecobalamin supplements did have
a significant impact. The scientists noted that "after
two years, all electrophysiologic indices of the nonparetic
side were significantly improved in the treated group
compared with those in the untreated group."
No one knows for sure how mecobalamin
works. Vitamin B12 is
involved in many body systems, but mecobalamin is the
only form used in the central nervous system where it
promotes nerve regeneration and remyelination. Regardless
of how mecobalamin works its magic, it is easily and
cheaply available. Direct supplementation with mecobalamin
costs less than $10 a month, not to mention that it's
absorbed better and retained longer than other B12
analogues, and is side effect free to boot.
J Neurol Sci Apr 15, 2005;231(1-2):13-8
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