A STUDY OF ASSESSMENT IN PERIPHERAL NEUROPATHY IN PATIENTS WITH NEWLY DETECTED THYROID DISORDERS IN A TERTIARY CARE TEACHING INSTITUTE

BACKGROUND Thyroid dysfunction is associated with characteristic symptoms, signs and functional alterations in many organs and systems. The purpose of this study was to evaluate objectively the functional changes in the peripheral nervous system and to determine the type and the prevalence of these diseases. The prevalence of neuromuscular disorders related to thyroid dysfunction has been reported to be between 20-80%. AIMS AND OBJECTIVES To study the correlation and prevalence of nerve conduction abnormalities in patients with thyroid dysfunction. To determine the type of peripheral neuropathy in these patients. MATERIALS AND METHODS This study was carried out in Medicine OPD and Endocrinology OPD over a period of 8 months; 50 consecutive patients with newly detected thyroid dysfunction and who fulfilled the inclusion criteria were included in the study and the required data were recorded from each subject with an in-person interview by administering a specific questionnaire. Nerve Conduction Study was performed in all these subjects by using the Standard RMS ENMG EP MARK II machine and results were correlated. RESULTS Out of the 50 patients studied 18 patients had neuropathy, of which 14 of them were hypothyroid and 4 of them had hyperthyroidism; 2 patients had mononeuropathy and 16 of them had polyneuropathy. Carpal tunnel syndrome was present in 2 individuals who had hypothyroidism; 14 patients had predominantly sensory neuropathy and 4 individuals had both sensory and motor polyneuropathy. The most common neurological abnormalities detected were sensory axonal polyneuropathy, mononeuropathy involving the sural nerve, mononeuritis multiplex pattern, carpal tunnel syndrome. CONCLUSION This study concludes that hypothyroid patients are more prone to develop neuropathy predominantly involving the sensory nerves of both lower limbs. This study clearly depicts that peripheral nervous system involvement is more often seen in patients with newly detected thyroid dysfunction. Electrophysiological studies help us in the diagnosis of this type of subclinical polyneuropathy. So nerve conduction studies can be included in the early part of diagnostic workup panel in newly detected thyroid illness.