University of Khartoum

Neurological Disorders in Sudanese Patients with Hypo and Hyperthyroidism

Neurological Disorders in Sudanese Patients with Hypo and Hyperthyroidism

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Title: Neurological Disorders in Sudanese Patients with Hypo and Hyperthyroidism
Author: Mohammed, Yasir
Abstract: Background: Thyroid dysfunction has multi-system involvement particularly on the central nervous system, commonly patients suffer from neurological dysfunctions. Objectives: To determine how common are the neurological and myopathic features in hypo and hyperthyroid Sudanese patients and to correlate these features with the symptoms, signs and biochemical profile in hypo and hperthyroidism (T3, T4, TSH and CPK). Methods: A descriptive prospective study was performed in 62 patients with thyroid dysfunction, 42 were hyperthyroid, and 20 were hypothyroid with neurological and myopathic features, at Khartoum Teaching Hospital and its referral clinics, during the period from November 2002 to September 2003. Data tabulated included personal data, symptoms of hyper and hypothyroidism, drug history, examination and investigations. Results: Neurological and myopathic features are common presentations in hyper and hypothyroidism (52%). Proximal myopathy was found in all 62 patients with hyper and hypothyroidism, peripheral neuropathy in 13(31%) of hyperthyroid and 12(6%) of hypothyroid patients. Most of our patients had neuropsychiatric manifestations in form of depression 34(81%) and 17(85%) in hyper and hypothyriod patients respectively. Hyperreflexia was found in 20(47.6%) and delayed reflexes in 13(65%) in hyper and hypothyroid patients respectively. Carpal-tunnel syndrome was present in 9(21.4%) and 9(45%) in hyper and hypothyroid patients respectively. Hand tremors and lid lag were found in 32(76%) and 21(50%) of hyperthyroid patients respectively. Hoarseness of voice VII and deafness were found in 13(65%) and 2(10%) of hypothyroid patients respectively. For correlation between general neurological and specifically myopathic features with thyroid function test, we found that proximal myopathy in hyperthyroid patients correlates only with serum T4. In hypothyroid myopathy there was no correlation with all thyroid function tests (TFTs). There was a correlation between hyperthyroid myopathy and serum C.P.K, which was not found in hypothyroid myopathy. Hyperreflexia of hyperthyroid patients correlates with serum TSH. Carpaltunnel syndrome correlates with serum TSH in hypothyroid patients. There was no correlation between peripheral neuropathy in hyper and hypothyroid patients and thyroid function tests. Conclusion neurological and myopathic manifestations are common presentations in patients with thyroid dysfunctions particularly proximal myopathy. The degree of myopathy correlated with the level of serum T4 and serum C.P.K in hyperthyroid patients and also there was correlation between hyper-reflexia and serum TSH in hyperthyroid patients. In hypothyroid patients carpaltnnel syndrome correlated with serum TSH level.
Description: 68page
URI: http://hdl.handle.net/123456789/8172
Date: 2015-04-02


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