Double Trouble: Concomitant Carpal Tunnel Syndrome and Guyon’s Canal Syndrome

Carpal tunnel syndrome (CTS) and Guyon's canal syndrome are distinct mononeuropathies of the median and ulnar nerves, respectively, but their simultaneous occurrence is rare. We present the case of a 54-year-old female who presented with numbness and tingling in both hands. Her physical exam revealed intact sensation bilaterally, full strength, and no muscle atrophy. Electrodiagnostic testing confirmed right-sided CTS and ulnar nerve entrapment at Guyon's canal. Normal latency and amplitude of the dorsal ulnar cutaneous nerve (DUCN) helped localize the lesion distally. The case highlights the importance of comprehensive electrodiagnostic testing, including DUCN evaluation, in identifying concomitant pathologies that may be overlooked clinically. Recognizing these pathologies is important for guiding management, particularly when overlapping symptoms are present.