Yıl: 2007 Cilt: 24 Sayı: 1 Sayfa Aralığı: 7 - 15 Metin Dili: Türkçe

Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients

Öz:
Amaç: Tiroid bezi hastalıklarının nöromuskuler disfonksiyona bağlı birçok semptom ve bulguları olabilir. Tiroid hastalıklarına bağlı nörolojik komplikasyonlar, hormonal değişiklikler ya da immün mekanizmalarla meydana gelir (1,19). Hem periferik hem de santral sinir sistemi etkilenebilir. Hastalık bazen bu nörolojik komplikasyonlarla ortaya çıkabileceği ve uygun tedavi ile kolayca düzelebileceği için erken tanı ve değerlendirme çok önemlidir. Bu çalışmanın amacı; yeni tanı almış, henüz tedaviye başlanmamış olan tiroid hastalarındaki periferik ve santral sinir sistemi etkileniminin araştırılmasıdır. Çalışma Planı: Çalışmaya periferik ve santral sinir sistemini etkileyecek başka bir hastalığı olmayan 22 hipotiroidili, 13 hipertiroidili olmak üzere toplam 35 hasta alındı. Elektrofizyolojik inceleme olarak; tek taraflı (sağ) üst ve alt ekstremitede sinir iletimleri, median uyarımlı somatosensoriyel uyandırılmış potansiyeller (SUP), iki taraflı göz kırpma refleksi çalışıldı. Yaş ve cinsiyet açısından eşleştirilmiş 30 sağlıklı birey kontrol grubu olarak alındı, sonuçlar karşılaştırıldı.Sonuçlar: Sinir iletimi incelemesinde; 13 (%59.09) hipotiroidi, 7 (%53,84) hipertiroidili hastada elektrofizyolojik patoloji tespit edildi. Hipotiroidi hasta grubunda; en fazla etkilenen sinir median motor ve duysal sinirlerdi. Karpal tünel sendromu (KTS) 11 (%50) hastada görüldü. Ilımlı düzeyde (%8-9) sensorimotor polinöropati vardı. Hipertiroidide ise nispeten polinöropati daha fazla (%15,4) idi ve sural nöropati ön plandaydı (%23,1). SUP incelemesinde; P25 latans uzaması en belirgin patolojik bulguydu ve hipotiroidide %45,45, hipertiroidide ise %38,46 oranında görülmekteydi. Göz kırpma refleksinde ise ipsi-kontralateral R2 süresindeki uzama en fazla rastlanan anormallikti. Bu da hipotiroidide %36,36 oranında ve hipertiroidide ise %23,07 oranında görülmekteydi.
Anahtar Kelime:

Tedavi başlanmamış tiroid hastalarında sinir iletileri, median sup ve göz kırpma refleksi

Öz:
The purpose of this study was to investigate the electrophysiological changes in the peripheral and central nervous system in recently diagnosed subclinical thyroid disease patients before any treatment. This study included 22 patients with hypothyroidism and 13 patients with hyperthyroidism who had no other disease which could affect peripheral or central nervous system. We performed nerve conduction studies, median nevre somatosensorial evoked potentials and blink reflex studies in 35 patients and 30 age and gender matched controls. Distal latency, compound muscle action potential amplitude, nerve conduction velocity, minumum F-latency were recorded in the motor nerve conduction studies, distal latency, sensorial nerve action potential amplitüde, nerve conduction velocity were recorded in the sensorial nerve conduction studies and cortical N20-P25 potential latencies were recorded during the median somatosensorial evoked potential study. Bilaterally R1, R2 and contralaterally R2 potentials were evaluated during the blink reflex studies. In the subclinical hypothyroid patients median motor and sensorial nerves were the most commonly affected nerves with carpal tunnel syndrom being positive in 54,5 % of these patients. Sensorimotor polyneuropathy was find in 8-9% of subclinical hypothyroid patients while this ratio was 15,38% in subclinical hyperthyroid patients. Sural neuropathy was found in 23,07% of subclinical hyperthyroid patients. A decrease in median, ulnar and sural sensorial nerve action potential amplitüdes and tibial motor nerve conduction velocities were the other findings in this group. During the median nerve SEP studies the most common pathological finding in all patients was an increase in P25 cortical latency. This was found in 45,45%
Anahtar Kelime:

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APA YÜKSEL G, KARLIKAYA G, TANRIDAĞ T, US Ö, AKYÜZ G (2007). Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients. Journal of Neurological Sciences (Turkish), 24(1), 7 - 15.
Chicago YÜKSEL Gülbin,KARLIKAYA Geysu,TANRIDAĞ Tülin,US Önder,AKYÜZ Gülseren Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients. Journal of Neurological Sciences (Turkish) 24, no.1 (2007): 7 - 15.
MLA YÜKSEL Gülbin,KARLIKAYA Geysu,TANRIDAĞ Tülin,US Önder,AKYÜZ Gülseren Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients. Journal of Neurological Sciences (Turkish), vol.24, no.1, 2007, ss.7 - 15.
AMA YÜKSEL G,KARLIKAYA G,TANRIDAĞ T,US Ö,AKYÜZ G Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients. Journal of Neurological Sciences (Turkish). 2007; 24(1): 7 - 15.
Vancouver YÜKSEL G,KARLIKAYA G,TANRIDAĞ T,US Ö,AKYÜZ G Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients. Journal of Neurological Sciences (Turkish). 2007; 24(1): 7 - 15.
IEEE YÜKSEL G,KARLIKAYA G,TANRIDAĞ T,US Ö,AKYÜZ G "Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients." Journal of Neurological Sciences (Turkish), 24, ss.7 - 15, 2007.
ISNAD YÜKSEL, Gülbin vd. "Nerve conduction studies, sep and blink reflex studies in recently diagnosed,untreated thyroid disease patients". Journal of Neurological Sciences (Turkish) 24/1 (2007), 7-15.