Abstract
Hypothyroidism causes neurological dysfunctions like peripheral & entrapment neuropathy, cerebellar ataxia, myxedema coma etc1. Studies show that motor symptoms increases with increase TSH levels. Nerve conduction study when conducted early in the course of disease helps in medical management of neuropathies before starting surgical treatment. This study assessed median motor parameters in recently diagnosed and untreated hypothyroid patients.
Objectives: To study the correlation between TSH values and median motor nerve parameters in newly diagnosed hypothyroid patients
Material & Methods: 270 hypothyroid males and females with age 20 to 50 years were included. Patients with neurological disorders, diabetes mellitus, those taking drugs causing neuropathy, alcoholics and smokers were excluded. Study design was descriptive All patients underwent electrophysiological studies in the department of Neuromedicine, GTDMC, Alappuzha for one year.
Study variables were distal latency, conduction velocity and amplitude of median motor nerve, TSH, fT3 & fT4. Median motor nerve parameters were correlated with TSH values and the results analysed statistically by SPSS software.
Results: Datas were analysed with SPSS version 18 using student t test and chi square test and p value <0.05 was considered as significant. Observations were represented both graphically and numerically.
Conclusion: In this study, strong association was found between TSH values and altered motor nerve parameters especially in distal latency. It may be due to entrapment neuropathy where deposition of mucinous substances around the peripheral nerves occurs. Early diagnosis and treatment can prevent the impairment of motor conduction parameters.
Keywords: Hypothyroidism, median nerve, Nerve conduction study.
References
- Prabir Sinha Roy, Arunima Chaudhuri1, Suranjan Banerjee et al. A study to detect abnormalities in nerve conduction velocities in newly diagnosed hypothyroid subjects .2015;15(2):187-92.
- Review of Medical Physiolgy. McGraw Hills Publications. 22nd edition. 2005; 317.
- Kristin Orstavik, Ingrid Norheim, et al. Neurology. 2006; vol. 67 :786-791
- Textbook of Endocrinology. Elsevier publications. 13th edition.2015; 3rd section.
- Dumitru D, Amato AA. Electrodiagnostic medicine. 2nd ed. Philadelphia; 2002; 947e948, 984.
- Ashwini A Mahadule, Pravin S Jadhao and Mrunal S Phatak. Motor conduction parameters in recently diagnosed and untreated hypothyroidism. Ann Neurosci. 2015;22(1):6-1
- Nemni R, Bottacchi E, Fazio R, Mamoli A, Corbo M, Camerlingo M, et al. Polyneuropathy in hypothyroidism: Clinical, electrophysiological and morphological findings in four cases. J Neurol Neurosurg Psychiatry 1987; 50:1454‑60.
- Jameson and Weetman AP. Disorders of thyroid gland. In: Principals of Harrison’s Internal Medicine.NewYork;2008.p.2230.
- De Krom MC, De Krom CJ SF. Carpal tunnel syndrome: diagnosis, treatment, prevention and its relevance to dentistry. Ned Tijdschr Tandheelkd.2009;97-101.
- Fariba Eslamian AB, Aghhamoham-madzadeh N,Niafar et al. Electrophysiological changes in patients with untreated primary Hypothyroidism.J Clin Neurophysiol.2011;28(3):322-8
- Adikesavan Balaraman, Goudhaman Natarajan et al. A study of nerve conduction velocity in newly diagnosed Hypothyroid patients.2013;9(4):198-201.
- Ahmed faraz, Taha Nafeez et al. Autoimmune Hyppothyroidism in patients with Neurofibromatosis 1.2015;27(4):1-2.
- Praveenkumar srikanteswara, Janardhan D et al. The Relationship between Nerve Conduction Study and clinical grading of carpal tunnel syndrome.2016;10(7):OC13-OC18
- Gaurav Kakkad, Nikita Bhatt, Jithendra Lakhani and SP. Electromyographic evaluation of blink reflex as a tool for early diagnosis of neurological dysfunction in patients of Hypothyroidism. Ann Neurosci.2013;20(3):95-8. 89
- Gabriel Bucurescu, MD M. Neurological manifestations of thyroid disease Clinical Presentation: History, Physical, Causes 2014
- Bagchi N, Brown TR, Parish RF Thyroid dysfunction in adults over age 55 years. A study in an urban U.S. community.1990; 150: 785-798.
- Meier C, Bischoff A. Polyneuropathy in hypothyroidism. Clinical and nerve biopsy study of 4 cases. J Neurol 1977;215:103-14.
- MD Hend Azhary,MD Muhammed U Farooq, MD Minal Bhanushali, et al. peripheral neuropathy: Differential Diagnosis and Management. Am Fam physician.2010;81(7):887-92. 19. Ettorre B, Mariad, Graziella BV et al. Hypothyroidism and polyneuropathy.J Neurol Neurosurg Psychiat.1989;52:1420-3.
Corresponding Author
Dr Sinu Sankar M
Third year PG, Physiology, Affiliated to TCMC
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.14
