Yıl: 2012 Cilt: 49 Sayı: 4 Sayfa Aralığı: 304 - 307 Metin Dili: Türkçe

Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması

Öz:
Amaç: Klinik hipotiroidili hastalarda akson veya miyelin tutulumuna bağlı sensorimotor polinöropati veya mononöropati bildirilmiştir fakat subklinik hipotiroidiye bağlı periferik nöropati tutulumuyla ilgili çelişkili sonuçlar bulunmaktadır. Bu çalışmada amacımız; nörolojik açıdan asemptomatik olan klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirlerde elektrofizyolojik değişiklikleri araştırmaktır. Yöntem: Çalışmaya nörolojik açıdan asemptomatik olan klinik hipotiroidili 15 hasta (30 el), subklinik hipotiroidili 18 hasta (36 el) alındı. Yaş ve cinsiyet açısından eşleştirilmiş 27 sağlıklı birey (54 el) kontrol grubu olarak alındı. Gruplarda median ve ulnar sinir elektrofizyolojik olarak değerlendirildi. Bulgular: Subklinik hipotiroidili hastalarda ulnar motor sinir iletim hızında (uMNCV) yavaşlama ve ulnar sinir duysal latansında (uSDL) uzama kontrol grubuna göre anlamlı bulundu. Klinik hipotiroidi ile kontrol grubu karşılaştırıldığında median motor distal latansında (mMDL) uzama, median motor iletim hızında (mMNCV) yavaşlama, median sinir birleşik kas aksiyon potansiyelinde (mBKAP) küçülme ve ulnar motor iletim hızında (uMNCV) anlamlı oranda yavaşlama bulundu. Klinik hipotiroidi ile subklinik hipotiroidi karşılaştırıldığında klinik hipotiroidili hastalarda subklinik hipotiroidililere göre mMDLde uzama ve mBKAP amplitüdünde küçülme bulundu. Median duysal iletim hızı (mSNCV), mMNCV, median duysal distal latans (mSDL), ulnar duysal iletim hızı (uSNCV), ulnar birleşik kas aksiyon potansiyeli (uBKAP) amplitüdü, uMDL, uMNCV değerleri arasında istatistiksel olarak anlamlı bir fark bulunmadı. Sonuç: Klinik ve subklinik hipotiroidili hastalarda nörolojik şikâyetler ortaya çıkmadan önce bile sinir iletim çalışmalarında anormallikler görülebilir. Bu hastalarda rutin sinir iletim çalışması yapılarak periferik nöropati açısından değerlendirilmelerinin erken tanı ve tedaviye katkısı olacağı kanaatindeyiz. (Nöropsikiyatri Arflivi 2012; 49: 304-307)
Anahtar Kelime:

Electrophysiological examination of the median and ulnar nerve in patients with clinical and subclinical hypothyroidism: A case-control study

Öz:
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)
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA ARIKANOĞLU A, ALTUN Y, UZAR E, ACAR A, ÇEVİK M, DEMİRCAN F, İNAL A, TAŞDEMİR N (2012). Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması. Nöropsikiyatri Arşivi, 49(4), 304 - 307.
Chicago ARIKANOĞLU Adalet,ALTUN YAŞAR,UZAR Ertuğrul,ACAR ABDULLAH,ÇEVİK Mehmet Uğur,DEMİRCAN Fatih,İNAL ALİ,TAŞDEMİR Nebahat Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması. Nöropsikiyatri Arşivi 49, no.4 (2012): 304 - 307.
MLA ARIKANOĞLU Adalet,ALTUN YAŞAR,UZAR Ertuğrul,ACAR ABDULLAH,ÇEVİK Mehmet Uğur,DEMİRCAN Fatih,İNAL ALİ,TAŞDEMİR Nebahat Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması. Nöropsikiyatri Arşivi, vol.49, no.4, 2012, ss.304 - 307.
AMA ARIKANOĞLU A,ALTUN Y,UZAR E,ACAR A,ÇEVİK M,DEMİRCAN F,İNAL A,TAŞDEMİR N Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması. Nöropsikiyatri Arşivi. 2012; 49(4): 304 - 307.
Vancouver ARIKANOĞLU A,ALTUN Y,UZAR E,ACAR A,ÇEVİK M,DEMİRCAN F,İNAL A,TAŞDEMİR N Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması. Nöropsikiyatri Arşivi. 2012; 49(4): 304 - 307.
IEEE ARIKANOĞLU A,ALTUN Y,UZAR E,ACAR A,ÇEVİK M,DEMİRCAN F,İNAL A,TAŞDEMİR N "Klinik ve subklinik hipotiroidili hastalarda median ve ulnar sinirin elektrofizyolojik incelemeleri: Olgu kontrol calışması." Nöropsikiyatri Arşivi, 49, ss.304 - 307, 2012.