Evaluation of prevalence of neuromuscular disorders in thyroid disorders in tertiary care institution – An interdepartmental inter institutional study

ABSTRACT

Background: The prevalence of Neuromuscular disorders in thyroid disorders is reported to be from 20% to 60% and varies from neuropathy to proximal myopathy. This study attempts to evaluate the prevalence of neuromuscular disorders in thyroid disorders. Aim and objectives: To study the correlation and prevalence of Nerve conduction abnormalities in hypothyroidism and hyperthyroidism, to determine neuropathy and myopathy in subsect of patients with thyroid disorders. Materials and methods: This study setting was in tertiary medical care centres which are major teaching institutes confined to the same geographical zone with a similar type of patient inflow. The departments of Medical endocrinology Out Patient patients and Endocrine surgery along with Internal medicine were included to evaluate patients. All patients were subjected to evaluation by Neurologist, Endocrine surgeons, Physician and Nuclear Physician. A total number of 400 patients over a period of three years were included from 2015 till 2018 with one year follow-up after treatment. The inclusion M.S. Senthil Kumar, Rajan Ganesan, A. Nithyanandham, E. Prabhu. Evaluation of prevalence of neuromuscular disorders in thyroid disorders in tertiary care institution - An interdepartmental inter institutional study. IAIM, 2019; 6(3) 176-181. Page 177 criteria were newly detected thyroid dysfunction predominantly hypothyroidism and hyperthyroidism and a subset of patients refractory to medical treatment where intervention was total thyroidectomy. The exclusion criteria were toxic nodules, thyroiditis, unmarried girls and postoperative disease states. All Patients were subjected to a questionnaire and nerve conduction study was performed using standard RMS ENMG EP Mark Ii Machine to derive results for comparative analysis. Results: Out of the 400 patients studied 144 had neuropathy of which 4 patients had hyperthyroidism and 56 had hypothyroidism. 8 patients had mononeuropathy and 64 had polyneuropathy. Proximal Myopathy was present predominantly in hyperthyroidism especially Graves’ disease. Conclusion: The outcome of the evaluation in the study revealed that hypothyroid patients predominantly had Neuropathy and Hyperthyroidism patients had proximal Myopathy especially in Graves’ disease. The commencement of hyperthyroidism especially in Graves’ Disease is significant along with commencement of therapy to assess the progression of proximal Myopathy which is prevalent three fold in Graves Disease than in hyperthyroidism.