Woo C C
J Manipulative Physiol Ther. 1988 Aug;11(4):314-21.
The neurological features of acromegaly are reviewed and two cases are reported. The most common neurological complications of active hypersomatotropism are headache, acroparesthesia and visual disturbance. Primary peripheral neuropathy, myopathy, entrapment myelopathy and/or cauda equina syndrome are uncommon, especially in young acromegalics. It is postulated that peripheral neuropathy in acromegaly is due to the entrapment of a nerve secondary to a soft tissue edematous mechanism by traumatic compression, angulation and/or stretching of the nerve in acquired extraspinal intermuscular, fibrous or osseofibrous tunnel stenosis; and/or in acquired spinal lateral recess stenosis, rather than true primary neuropathic or secondary endocrinological complications of hypersomatotropism. Proximal weakness is more likely arthropathic rather than myopathic, neuropathic or endocrinologic. Differential diagnosis of backache is briefly discussed. Further investigations of the mechanisms and the conservative treatment for neurological involvements in acromegaly are needed.
本文回顾了肢端肥大症的神经学特征并报告了两例病例。活动性生长激素分泌过多最常见的神经学并发症是头痛、肢端感觉异常和视觉障碍。原发性周围神经病、肌病、卡压性脊髓病和/或马尾综合征并不常见，尤其是在年轻的肢端肥大症患者中。据推测，肢端肥大症中的周围神经病是由于神经在获得性脊柱外肌间、纤维或骨纤维隧道狭窄中因创伤性压迫、成角和/或拉伸导致软组织水肿机制而受压，以及/或者在获得性脊柱侧隐窝狭窄中受压，而非真正的原发性神经病变或生长激素分泌过多的继发性内分泌并发症。近端肌无力更可能是关节病性的，而非肌病性、神经病变性或内分泌性的。本文简要讨论了背痛的鉴别诊断。需要进一步研究肢端肥大症神经受累的机制及保守治疗方法。
