Klinik ve Subklinik Hipotiroidili Hastalarda Median ve Ulnar Sinirin Elektrofizyolojik Incelemeleri: Olgu Kontrol Çalismasi/Electrophysiological Examination of the Median and Ulnar Nerve in Patients with Clinical and Subclinical Hypothyroidism: A Case-Control Study

ÖZET. Amaç: Klinik hipotiroidili hastalarda akson veya miyelin tutulumuna bagli sensorimotor polinöropati veya mononöropati bildirilmistir fakat subklinik hipotiroidiye bagli periferik nöropati tutulumuyla ilgili çeliskili sonuçlar bulunmaktadir. Bu çalismada amacimiz; nörolojik açidan asemptomatik olan klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirlerde elektrofizyolojik degisiklikleri arastirmaktir. Yöntem: Çalismaya nörolojik açidan asemptomatik olan klinik hipotiroidili 15 hasta (30 el), subklinik hipotiroidili 18 hasta (36 el) alindi. Yas ve cinsiyet açisindan eslestirilmis 27 saglikli birey (54 el) kontrol grubu olarak alindi. Gruplarda median ve ulnar sinir elektrofizyolojik olarak degerlendirildi. Bulgular: Subklinik hipotiroidili hastalarda ulnar motor sinir iletim hizinda (uMNCV) yavaslama ve ulnar sinir duysal latansinda (uSDL) uzama kontrol grubuna göre anlamli bulundu. Klinik hipotiroidi ile kontrol grubu karsilastirildiginda median motor distal latansinda (mMDL) uzama, median motor iletim hizinda (mMNCV) yavaslama, median sinir birlesik kas aksiyon potansiyelinde (mBKAP) küçülme ve ulnar motor iletim hizinda (uMNCV) anlamli oranda yavaslama bulundu. Klinik hipotiroidi ile subklinik hipotiroidi karsilastirildiginda klinik hipotiroidili hastalarda subklinik hipotiroidililere göre mMDL'de uzama ve mBKAP amplitüdünde küçülme bulundu. Median duysal iletim hizi (mSNCV), mMNCV, median duysal distal latans (mSDL), ulnar duysal iletim hizi (uSNCV), ulnar birlesik kas aksiyon potansiyeli (uBKAP) amplitüdü, uMDL, uMNCV degerleri arasinda istatistiksel olarak anlamli bir fark bulunmadi. Sonuç: Klinik ve subklinik hipotiroidili hastalarda nörolojik sikâyetler ortaya çikmadan önce bile sinir iletim çalismalarinda anormallikler görülebilir. Bu hastalarda rutin sinir iletim çalismasi yapilarak periferik nöropati açisindan degerlendirilmelerinin erken tani ve tedaviye katkisi olacagi kanaatindeyiz. (Nöropsikiyatri Arflivi 2012; 49: 304-307). Anahtar kelimeler: Klinik hipotiroidi, subklinik hipotiroidi, median sinir, ulnar sinir, nöropati. Çikar çatismasi: Yazarlar bu makale ile ilgili olarak herhangi bir çikar çatismasi bildirmemislerdir. ABSTRACT. Background: Sensorimotor polyneuropathy or mononeuropathy caused by damage of axon or myelin have been reported in patients with clinical hypothyroidism; however, there are conflicting results concerning peripheral neuropathy involvement due to subclinical hypothyroidism. Our aim in this study was to investigate the electrophysiological changes in median and ulnar nerves in patients with clinical hypothyroidism or subclinical hypothyroidism that is asymptomatic from the neurological point of view. Method: 15 patients (30 hands) with clinical hypothyroidism (group 1) and 18 patients (36 hands) with subclinical hypothyroidism (group 2), who were asymptomatic from the neurological point of view, were included in the study. 27 age- and gender-matched healthy individuals (54 hands) were taken as a control group. The median and ulnar nerves were assessed electrophysiologically in the groups. Results: Slowing of ulnar motor nerve conduction velocity (uMNCV) and ulnar nerve sensory latency (uSDL) elongation values in group 2 were found to be significant compared to the control group. When group 1 was compared with the control group, elongation in the median motor distal latency (mMDL), slowing in median motor conduction velocity (mMNCV), reduction in median nerve compound muscle action potential (mCMAP), and a significant decrease in ulnar motor conduction velocity (uMNCV) were found in group 1. When group 1 was compared with group 2, in patients with clinical hypothyroidism, elongation in mMDL and amplitude reduction in mCMAP were found, no statistically significant differences were found between the groups in terms of median sensory nerve conduction velocity (mSNCV), mMNCV, median distal sensory latency (mSDL), uMNCV, ulnar sensory nerve conduction velocity (uSNCV), ulnar compound muscle action potential (uCMAP), and uMDL values. Conclusion: Even before the emergence of neurological symptoms in patients with clinical and subclinical hypothyroidism, abnormalities can be detected in nerve conduction studies. We believe that, assessment of these patients for peripheral neuropathy by conducting routine nerve conduction studies will contribute to early diagnosis and treatment. (Archives of Neuropsychiatry 2012; 49: 304-307). Key words: Clinical hypothyroidism, subclinical hypothyroidism, the median nerve, ulnar nerve, neuropathy. Conflict of interest: The authors reported no conflict of interest related to this article.

© Galenos Yayinevi 2012. Provided by ProQuest LLC. All Rights Reserved.

The use of this website is subject to the following Terms of Use