Research Center of Physical Medicine and Rehabilitation, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
J Clin Neurophysiol. 2011 Jun;28(3):323-8. doi: 10.1097/WNP.0b013e31821c30d9.
Thyroid diseases may cause signs and symptoms of neuromuscular dysfunction. Hypothyroidism has been associated with the clinical features of proximal muscle weakness, mononeuropathy, and sensorimotor polyneuropathy. This study aimed at evaluating the electrophysiologic findings in patients with untreated spontaneous hypothyroidism and comparing them with a healthy control group. In a case-control cross-sectional study, 40 patients with definite diagnosis of clinical hypothyroidism and 40 healthy control subjects were evaluated by electromyography and nerve conduction studies in the specialized clinic of the Tabriz University of Medical Sciences during an 18-month period. Seven male and 33 female patients with a mean age of 39.5 ± 11.8 years were enrolled. In this group, there were 12 cases (30%) with clinical muscle weakness, with severity of approximately 4/5, 18 cases (45%) with decreased or absent deep tendon reflexes, 6 cases (15%) with neuropathy, including 4 sensory and 2 sensorimotor, of which 5 cases were mild and 1 case was moderate, 3 cases (7.5%) with myopathy, and 13 cases (32.5%) with carpal tunnel syndrome, which was mild in 7, moderate in 10, and severe in 2 hands. Patients with neuropathy were significantly older than those without neuropathy (P = 0.001). There was no significant relation between gender, duration of the disease, serum TSH level, and the presence of clinical muscle weakness with the occurrence of neuropathy or myopathy. Female gender, increasing age, duration of the disease, and the frequency of clinical weakness were, however, significantly related to the presence of carpal tunnel syndrome (P < 0.05). In conclusion, in patients with untreated primary hypothyroidism, majority had the carpal tunnel syndrome. Mild neuropathy mainly of sensory type and myopathy were uncommon and rare findings, respectively. Early treatment would hinder the progression of mentioned abnormalities and minimize their occurrence.
甲状腺疾病可能导致神经肌肉功能障碍的迹象和症状。甲状腺功能减退症与近端肌肉无力、单神经病和感觉运动性多发性神经病的临床特征有关。本研究旨在评估未经治疗的自发性甲状腺功能减退症患者的电生理发现，并将其与健康对照组进行比较。在一项病例对照横断面研究中，在 18 个月的时间里，我们在大不里士医科大学的专门诊所评估了 40 名确诊为临床甲状腺功能减退症的患者和 40 名健康对照组的肌电图和神经传导研究。纳入的 40 名患者中有 7 名男性和 33 名女性，平均年龄为 39.5 ± 11.8 岁。在该组中，有 12 例（30%）有临床肌肉无力，严重程度约为 4/5，18 例（45%）有降低或缺失的深腱反射，6 例（15%）有神经病，包括 4 例感觉神经病和 2 例感觉运动神经病，其中 5 例为轻度，1 例为中度，3 例（7.5%）有肌病，13 例（32.5%）有腕管综合征，其中 7 例为轻度，10 例为中度，2 例为重度。有神经病的患者明显比没有神经病的患者年龄大（P = 0.001）。性别、疾病持续时间、血清 TSH 水平与临床肌肉无力的存在与神经病或肌病的发生之间无显著关系。然而，女性、年龄增长、疾病持续时间和临床无力的频率与腕管综合征的存在显著相关（P < 0.05）。总之，在未经治疗的原发性甲状腺功能减退症患者中，大多数患有腕管综合征。轻度感觉神经病和肌病分别为常见和罕见的发现。早期治疗将阻碍这些异常的进展并最小化其发生。
