Nerve Conduction Studies and Measurement of Median Nerve Cross-Sectional Area in Patients Newly Diagnosed with Hypothyroidism

Year 2023, , 367 - 71, 15.05.2023

Aydın Talip Yıldoğan Gözde Öngün Fettah Eren Hasan Kara Abdullah Erdem Akkulak Cem Onur Kıraç Süleyman Baldane İlknur Albayrak Recep Aygül

https://doi.org/10.37990/medr.1167201

Abstract

Aim: This study aimed to investigate the rate of carpal tunnel syndrome (CTS) and polyneuropathy in patients with new-diagnosed hypothyroidism and the relationship between median nerve conduction and the cross-sectional area of the median nerve by ultrasonography.
Material and Methods: It was a prospective, cross-sectional and case-control study. This study included thirty-five new-diagnosed hypothyroidism cases and thirty-five healthy controls. Bilateral sensory and motor nerve potentials were noted in the lower and upper extremities. The cross-sectional area of the median nerve was examined at the entrance of the CT with the axial plan by ultrasonography. The relationship between the cross-sectional areas of the median nerve and nerve conduction parameters was investigated.
Results: CTS was determined electrophysiologically in 8 (22.9%) patients. The control group had no CTS. There was no significant electrophysiological finding to support polyneuropathy in the patients. The cross-sectional areas of the median nerve were higher in the patient group but did not reach statistically significant (p>0.05). There was a positive correlation between the right and left cross-sectional area of median nerves and body mass index (BMI) (p<0.05).
Conclusion: The rate of CTS is high in patients with newly diagnosed hypothyroidism. There is a positive correlation between cross-sectional nerve areas and BMI. There was no significant correlation between nerve conductions and median nerve ultrasonographic cross-sectional areas.

Keywords

Nerve conduction, hypothyroidism, neuropathy, ultrasonography

References

• Gupta, N., Arora, M., Sharma, R., & Arora, K. S. (2016). Peripheral and central nervous system involvement in recently diagnosed cases of hypothyroidism: an electrophysiological study. Ann Med Res , 2016; 6: 261-266.
• Holováčová D, Kužma M, Killinger Z, Payer. Cross-sectional area of the median nerve is increased in primary autoimmune hypothyroidism and decreases upon treatment with thyroxine. Eur J Endocrinol 2016; 175: 265-71.
• Muscle AAoEMJ, Nerve. Guidelines in electrodiagnostic medicine. 1992;15: 229-253.
• Stevens JCJM, Medicine NOJotAAoE. AAEM minimonography 26: the electrodiagnosis of carpal tunnel syndrome. 1997;20(12):1477-1486.
• Aygül R, Ulvi H, Karatay S, Deniz O, Varoglu AO. Determination of sensitive electrophysiologic parameters at follow-up of different steroid treatments of carpal tunnel syndrome. J ClinNeurophysiol 2005;22: 222-230.
• Tankisi H, Pugdahl K, Fuglsang-Frederiksen A, et al. Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies, Suggested guidelines. ClinNeurophysiol 2005; 116: 1571-80.
• Wong S, Griffith J, Hui A, Tang A, Wong KJA. Discriminatory sonographic criteria for the diagnosis of carpal tunnel syndrome. Arthritis Rheumatol 2002; 46: 1914-21.
• Gupta N, Arora M, Sharma R, Arora. Peripheral and central nervous system involvement in recently diagnosed cases of hypothyroidism: an electrophysiological study. Ann med health sci res 2016; 6: 261-6.
• Duyff RF, Van den Bosch J, Laman DM, van Loon B-JP, Linssen WH. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J. Neurol. Neurosurg. Psychiatry 2000; 68: 750-5.
• Kececi H, Degirmenci Y. Hormone replacement therapy in hypothyroidism and nerve conduction study. ClinNeurophysiol2006; 36: 79-83.
• Asia A, Warkar AJIJoB, Research AM. Nerve conduction studies in recently diagnosed untreated hypothyroid patients. IJBAMR 2015; 4: 330-4.
• Hamdy M, Hafez AE, Khalil A, Mohamed FA. Diagnostic role of neuromuscular ultrasound in cubital tunnel syndrome.Int J ClinRheumtol. 2020; 14: 288.
• Beghi E, Delodovici ML, Bogliun G, et al. Hypothyroidism and polyneuropathy. J. Neurol Neurosurg Psychiatry 1989; 52: 1420-3.
• Garg, R., Bansal, N., Singh, N., Maria, A. K., Arora, K. S. Nerve conduction studies in newly diagnosed cases of hypothyroidism. SchAcad J Biosci 2015; 3: 479-88.
• Yüksel G, Karlıkaya G, Tanridağ T, Önder U, Akyüz G. Nerve conduction studies, SEP and blink reflex studies in recently diagnosed, untreated thyroid disease patients. J Neurol Sci 2007; 24: 7-15.
• Akarsu EO, Acar H, Ozer F, et al. Electromyographic findings in overt hypothyroidism and subclinical hypothyroidism. Turk Noroloji Derg 2013; 19: 128-33.