Clinical and pathogenic features of entrapment neuropathy in patient’s hands with acromegaly
A S Nikishchencova , S N Zhulev , N M Zhulev , Yu Sh Khalimov , O A Zagrebelnaya , M N Karpenko , T M Alekseeva , T N Trofimova , E V Shiryaeva , V S Zhulev
Bulletin of the Russian Military Medical Academy ›› 2018, Vol. 20 ›› Issue (2) : 120 -123.
Clinical and pathogenic features of entrapment neuropathy in patient’s hands with acromegaly
For specification of entrapment neuropathies pathogenesis in patients with acromegaly clinical and electroneurophysiological trial of the nerveswere conducted. It was determined that motor disorders in patients with incomplete remission of an acromegalia were more often than in patients with full remission. A significant difference between the frequency of occurrence of sensitive disturbances in patients with incomplete and full remission of acromegalia was not revealed. Expression of disturbances of the majority of electroneurophysiological indicators was more appreciable in patients with incomplete remission. In patients with incomplete remission the moderated and expressed disturbances prevailed, and patients from full remission had mild disturbances. The neurologic symptomatology of tunnel neuropathies and electroneuromyography disturbances were more expressed in group with incomplete remission. Conservative therapy of tunnel neuropathies was more effective in patients with full remission of acromegaly. It was revealed that the durability of acromegalia and accompanying pathology of a patient also influences expression of neurologic symptomatology and effect of the treatment. The lesser the durability of acromegalia, the better treatment results of neuropathies. The data obtained with a magnetic and resonant tomography on growth existence round a tendon of a flexor, regional growth of a bone trapeze and augmentation of transversal section of a median nerve and as signal strength change from it allow to specify a pathophysiology of tunnel neuropathies in acromegalia. The combined use of an electroneuromyography and a magnetic and resonant tomography possesses high informational content in diagnostics of tunnel neuropathies. These methods allow giving an objective assessment of changes of neuromuscular changes in patients with a syndrome of the carpal channel with acromegalia. Specification of a pathogenesis of tunnel neuropathies allows carrying out correction of agents and treatment methods in patients with acromegalia, thus reaching good results of treatment in short terms.
tunnel neuropathy / acromegaly / electroneuromyography / median nerve / ulnar nerve / magnetic and resonant tomography / syndrome of the carpal channel / somatotropic hormone of a pituitary body / insulinoid factor of body height-1
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Nikishchencova A.S., Zhulev S.N., Zhulev N.M., Khalimov Y.S., Zagrebelnaya O.A., Karpenko M.N., Alekseeva T.M., Trofimova T.N., Shiryaeva E.V., Zhulev V.S.
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