Kececi H, Degirmenci Y
Abant Izzet Baysal University, Duzce Medical Faculty, Department of Neurology, 14450 Konuralp, Duzce, Turkey.
Neurophysiol Clin. 2006 Mar-Apr;36(2):79-83. doi: 10.1016/j.neucli.2006.04.001. Epub 2006 Apr 25.
To evaluate the electrodiagnostic evidence of peripheral nerve dysfunction in patients with hypothyroidism before and after hormone replacement treatment.
Forty patients aged above 18 years diagnosed with hypothyroidism were included in our study. Patients with FT4 levels below 11.6 pmol/l and TSH levels above 4.2 IU/ml were accepted as hypothyroidic. Electrodiagnostic evaluation was performed at the onset of the study and after 3 months. Electrodiagnostic evaluation included motor and sensory nerve conduction studies, and F wave.
The differences between pre- and post-treatment FT4, FT3 and TSH values were found to be statistically significant. At the onset, electrophysiological evaluation revealed carpal tunnel syndrome in 15 patients and polyneuropathy in seven patients; whereas 18 patients were found normal in these respects. After treatment, the electrodiagnostic evaluation revealed that 35 patients were normal, while only two patients had carpal tunnel syndrome and three patients had polyneuropathy. The differences between before and after treatment values of median motor distal latency and amplitude, median sensorial nerve conduction velocity, tibial motor nerve conduction velocity and sural sensory nerve conduction velocity were found to be statistically significant.
The results of the control evaluation after treatment demonstrated that the findings related to entrapment neuropathy and polyneuropathy in hypothyroid patients can be reversible in a period of 3 months if appropriate hormone replacement treatment can be obtained. Especially in the treatment of entrapment neuropathy in hypothyroidism, the chance of medical treatment must be given to patients before considering surgical treatment.
评估甲状腺功能减退患者在激素替代治疗前后周围神经功能障碍的电诊断证据。
本研究纳入了40例年龄在18岁以上诊断为甲状腺功能减退的患者。FT4水平低于11.6 pmol/l且TSH水平高于4.2 IU/ml的患者被视为甲状腺功能减退。在研究开始时和3个月后进行电诊断评估。电诊断评估包括运动和感觉神经传导研究以及F波。
发现治疗前后FT4、FT3和TSH值的差异具有统计学意义。开始时，电生理评估显示15例患者患有腕管综合征，7例患者患有多发性神经病；而在这些方面有18例患者正常。治疗后，电诊断评估显示35例患者正常，而只有2例患者患有腕管综合征，3例患者患有多发性神经病。发现正中运动神经远端潜伏期和波幅、正中感觉神经传导速度、胫神经运动神经传导速度和腓肠感觉神经传导速度治疗前后的值之间的差异具有统计学意义。
治疗后的对照评估结果表明，如果能获得适当的激素替代治疗，甲状腺功能减退患者与卡压性神经病和多发性神经病相关的表现可在3个月内逆转。特别是在治疗甲状腺功能减退的卡压性神经病时，在考虑手术治疗之前必须给予患者药物治疗的机会。
