Carpal tunnel syndrome is a complex of symptoms as a result of compression of 
the median nerve in the carpal tunnel. As nerve entrapment induces impairment of 
somatic fibres followed by clinical symptoms and signs of the syndrome, one can 
assume that sympathetic fibres are involved too. Results of studies focused on 
this problem show presence of sympathetic symptoms in about half of patients, 
including Raynaud phenomenon, blanching of hands, painful swelling of fingers, 
dry or excessive sweating of palms. Activity of sympathetic system can be 
investigated by means of sympathetic skin response and vasomotor response. Eight 
papers presenting the results of sympathetic skin response from median nerve in 
carpal tunnel syndrome were analysed. Results of 4 studies showed decreased 
sympathetic activity, in 2 findings were equivocal and 2 studies failed to 
reveal any abnormalities. The following variables were considered in the 
interpretation of sympathetic skin response curve: amplitude, latency and area 
under the chart, each of them having limited diagnostic value due to inter-and 
intrasubject variation of these parameters. Vasomotor response was investigated 
in 2 studies by means of Doppler ultrasound flow examination in digital 
arteries. Results of both studies showed decreased vasomotor response in carpal 
tunnel syndrome. The review of current knowledge on sympathetic impairment in 
carpal tunnel syndrome fails to provide a definitive determination of its range 
and clinical consequences. It confirms, however, that routine examination of 
sympathetic disturbances is unnecessary due to their minor clinical 
significance.