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近期诊断的甲状腺功能减退症病例中的外周和中枢神经系统受累:一项电生理研究。

Peripheral and Central Nervous System Involvement in Recently Diagnosed Cases of Hypothyroidism: An Electrophysiological Study.

作者信息

Gupta N, Arora M, Sharma R, Arora K S

机构信息

Department of Physiology, Guru Gobind Singh Medical College, Faridkot, Punjab, India.

Department of Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India.

出版信息

Ann Med Health Sci Res. 2016 Sep-Oct;6(5):261-266. doi: 10.4103/amhsr.amhsr_39_16.

Abstract

BACKGROUND

Hypothyroidism, one of the most common endocrine disorders, may induce neurological abnormalities at an early stage of the disease.

AIM

The study was designed to assess the electrophysiological alterations of some selected variables of nerve conduction, brainstem auditory evoked potentials (BAEPs), and visual evoked potentials (VEPs) in hypothyroid patients.

SUBJECTS AND METHODS

Sixty patients of newly diagnosed hypothyroidism and an equal number of age-matched controls were selected for the study. Nerve conduction studies that included parameters as latencies, conduction velocities, and amplitude of motor nerves, i.e., median, ulnar, common peroneal, tibial nerve, and sensory nerves, i.e., median and sural nerves was performed in both hypothyroid patients and controls. Further, BAEPs and VEPs of all the patients were done. The data were compiled and statistically analyzed using Student's unpaired -test to observe any electrophysiological alterations in hypothyroid patients as compared to healthy controls.

RESULTS

On comparative evaluation, statistically significant increase in latency of median, ulnar, tibial, and sural nerves; decrease in conduction velocities of all the tested nerves and decrease in amplitude of median, tibial, and sural nerves was observed in hypothyroid patients. Statistically significant increase in latencies, interpeak latencies, and decrease in amplitudes of BAEP waves and statistically significant increase in P100 latency of VEP was seen in hypothyroid patients.

CONCLUSION

The results of our study suggest that peripheral and central neuropathy develops in patients of hypothyroidism at an early stage of disease and the electrophysiological investigations of such patients can help in timely detection and treatment of neurological disorders that occur due to thyroid hormone deficiency.

摘要

背景

甲状腺功能减退症是最常见的内分泌疾病之一,在疾病早期可能诱发神经功能异常。

目的

本研究旨在评估甲状腺功能减退患者某些选定的神经传导变量、脑干听觉诱发电位(BAEP)和视觉诱发电位(VEP)的电生理改变。

研究对象与方法

选取60例新诊断的甲状腺功能减退患者和同等数量年龄匹配的对照组进行研究。对甲状腺功能减退患者和对照组均进行神经传导研究,包括运动神经(即正中神经、尺神经、腓总神经、胫神经)和感觉神经(即正中神经和腓肠神经)的潜伏期、传导速度和波幅等参数。此外,对所有患者进行BAEP和VEP检测。收集数据并采用Student非配对t检验进行统计学分析,以观察甲状腺功能减退患者与健康对照组相比的任何电生理改变。

结果

通过比较评估,发现甲状腺功能减退患者正中神经、尺神经、胫神经和腓肠神经的潜伏期有统计学意义的增加;所有检测神经的传导速度降低,正中神经、胫神经和腓肠神经的波幅降低。甲状腺功能减退患者BAEP波的潜伏期、峰间潜伏期有统计学意义的增加,波幅降低,VEP的P100潜伏期有统计学意义的增加。

结论

我们的研究结果表明,甲状腺功能减退患者在疾病早期会出现周围和中枢神经病变,对此类患者进行电生理检查有助于及时发现和治疗因甲状腺激素缺乏引起的神经疾病。

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