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Median nerve conduction studies and wrist magnetic resonance imaging in acromegalic patients with carpal tunnel syndrome.
- Source :
-
Pituitary [Pituitary] 2015 Oct; Vol. 18 (5), pp. 695-700. - Publication Year :
- 2015
-
Abstract
- Purpose: Carpal tunnel syndrome (CTS) often occurs with acromegaly; however, the pathophysiology of CTS in acromegalic patients remains unclear. This study evaluated the median nerve in acromegalic patients with and without CTS.<br />Methods: We examined the median nerves of 21 acromegalic patients (eight patients with CTS and 13 patients without CTS) using electrophysiological nerve conduction studies and wrist magnetic resonance images. They underwent transsphenoidal surgery to resect their growth hormone-secreting pituitary adenomas. The median nerves of the patients with CTS were reassessed by the same studies.<br />Results: The sensory conduction velocity was significantly later in the median nerves of patients with CTS than in patients without CTS (34.9 vs. 45.8 m/s, respectively; P = 0.006). In the wrist magnetic resonance images, the cross-sectional area of the median nerve in CTS patients and non-CTS patients was 18.7 and 10.5 mm(2), respectively. The median nerve was significantly larger in patients with CTS than in patients without CTS (P < 0.003). The flattering ratio of the median nerve and palmar deviation of the flexor retinaculum were not significantly different between the two patient groups. After tumor resection, the nerve conduction velocities improved in patients with CTS, but the nerve remained enlarged. The CTS symptoms disappeared in all patients, except one.<br />Conclusions: The median nerves of acromegalic patients with CTS were enlarged and had impaired nerve conduction. This finding represents a predominant intrinsic feature in the pathophysiology of the disease rather than an extrinsic feature such as a thickened transverse carpal ligament.
- Subjects :
- Acromegaly diagnosis
Acromegaly etiology
Adenoma diagnosis
Adenoma surgery
Adult
Aged
Carpal Tunnel Syndrome etiology
Carpal Tunnel Syndrome pathology
Carpal Tunnel Syndrome physiopathology
Female
Growth Hormone-Secreting Pituitary Adenoma diagnosis
Growth Hormone-Secreting Pituitary Adenoma surgery
Humans
Male
Middle Aged
Predictive Value of Tests
Recovery of Function
Treatment Outcome
Adenoma complications
Carpal Tunnel Syndrome diagnosis
Growth Hormone-Secreting Pituitary Adenoma complications
Magnetic Resonance Imaging
Median Nerve pathology
Median Nerve physiopathology
Neural Conduction
Neurologic Examination
Wrist innervation
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7403
- Volume :
- 18
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Pituitary
- Publication Type :
- Academic Journal
- Accession number :
- 25663441
- Full Text :
- https://doi.org/10.1007/s11102-015-0642-9