Sympathetic skin responses in patients with hyperthyroidism.

BACKGROUND: The aim of this study was to investigate the disorders of sympathetic nervous system in patients with hyperthyroidism using sympathetic skin response (SSR). MATERIAL AND METHODS: Twenty-two newly diagnosed cases with hyperthyroidism were included in the study. The results were compared with those of 20 healthy controls. SSR was recorded with the contralateral electrical stimulation of the median nerve (of the upper extremities) and tibial nerve (of the lower extremities) with active electrodes placed on palms and soles and reference electrodes attached on the dorsal aspects of hands and feet. RESULTS: Ages of the cases with hyperthyroidism and controls ranged between 15-65 years (mean: 46.7 +/- 15.0 years) and 24-62 years (mean: 39.6 +/- 9.8 years) respectively (p > 0.05). In all the control subjects SSR could be obtained, while from the lower extremities of 4 cases with hyperthyroidism (18.0%) SSR could not be elicited. Mean SSR latencies of lower extremities were found significantly longer than control group (p < 0. 05). No difference was detected between mean amplitudes of SSR in upper and lower extremities. CONCLUSION: These findings suggest that SSR is useful for investigation of sympathetic nervous system involvement in cases with hyperthyroidism.

Ulnar nerve entrapment at wrist associated with carpal tunnel syndrome.

In this study, ulnar nerve entrapments at the wrist were investigated using nerve conduction studies in cases with established diagnosis of carpal tunnel syndrome (CTS). Cases with cervical radiculopathy and polyneuropathy as well as patients with ulnar nerve entrapment at elbow were excluded from the study. Fifty-three cases (46 females, seven males) whose ages ranged between 20 and 72 years (mean: 49.31 +/- 13.78) were evaluated. Among 53 cases, 12 (22.6%) bilateral and 41 (77.3%) unilateral CTS were detected. Totally 65 wrists evaluated and prolongation of median nerve wrist-3rd digit distal sensory latencies (DSL; N: 59; 90.7%) and wrist-abductor pollicis brevis distal motor latencies (N: 48; 73.8%) were seen. In six wrists, diagnoses were established with the detection of an increase in the differences between wrist-4th digit DSL of median and ulnar nerve. This test was used if other test results were in normal limits. Prolongation of ulnar nerve wrist-5th digit DSL were found in 12 wrists (18.4%) in cases with CTS. Among these 12 wrists mild (N: 2), moderate (N: 7) and severe (N: 3) CTS were detected. Ulnar nerve motor conduction studies provided normal results. In conclusion, we are in the opinion that for the detection of associated ulnar nerve wrist entrapments, ulnar nerve conduction studies paying special attention to DSL convey importance in established cases with CTS.

A-waves and electrophysiologically established diagnoses.

The aim of this study was to investigate the presence of A-waves in cases referred to our electromyography laboratory with various diagnoses and documentation of electrophysiologic diagnoses with A-waves. In cases where at least 3 motor nerves were analysed, during F response studies, A-waves having stabile latencies and amplitudes from minimum one third of submaximal and supramaximal stimuli were evaluated. Electrophysiologic diagnoses and the related nerves of cases with A-waves were recorded. A-waves were obtained from 38 out of 1604 cases (2.36%). Most of the cases (57.8%) with established A-waves consisted of patients with radiculopathies. A-waves were detected mostly in tibial nerve. Electrophysiologic analysis of 5 cases with A-waves has given normal results. Although mechanism of A-waves is not known completely, we suggest when obtained it must be remarked during routine electrophysiologic examination.