IJCRR - 9(5), March, 2017
Pages: 38-40
Reversible Alteration of Blink Reflex in Hypothyroid Patients in Response to Treatment
Author: Sharma G.1, Aprajita2, Aggarwal S.3
Category: Healthcare
[Download PDF]
Abstract:
Background: Hypothyroidism is associated with central and peripheral nervous system disturbances. It affects the CNS due to the impairment of the sensory pathways secondary to hormonal imbalances causing segmental demyelination. It also affects the transmission of impulses along the complex polysynaptic pathways, such as those mediating the blink reflex.
Objective: Evaluation of Blink Reflex for early diagnosis of neurological dysfunction in hypothyroid patients and to study the response to treatment.
Method: Blink Reflex was recorded using RMS EMG EP MK2 machine in 30 overt hypothyroid patients (serum TSH ?10 mIU/L) between 18 – 50 years of age who were followed up after 3 months of treatment.
Result: The latency of blink reflex showed an early ipsilateral R1 response and late R2 responses (ipsilateral R2i, contralateral R2c) which were found to be prolonged in the patients. Following the hormonal replacement therapy the latency tend to decrease while the amplitude was increased.
Conclusion: Increased latency of blink reflex indicates impairment predominantly of the sensory pathways. These changes are further more altered in untreated patients in the advanced stage of the disease. Hence blink reflex is useful non-invasive tool for early detection of cranial neuropathy in newly diagnosed hypothyroid patients and to access their response to treatment.
Keywords: Central Nervous System (CNS), Thyroid Stimulating Hormone (TSH), Blink reflex (BR)
Citation:
Sharma G.1, Aprajita2, Aggarwal S.3. Reversible Alteration of Blink Reflex in Hypothyroid Patients in Response to Treatment International Journal of Current Research and Review. 9(5), March, 38-40
References:
1. Khedr EM, El Toony LF, Tarkhan MN, Abdella G. Peripheral and central nervous system alterations in hypothyroidism: electrophysiological findings. Neuropsychobiology. 2000 Jan;41(2):88–94.
2. Cakir M, Samanci N, Balci N, Balci MK. Musculoskeletal manifestations in patients with thyroid disease. Clin Endocrinol (Oxf). 2003 Aug;59(2):162–7.
3. Nazliel B, Ylmaz MM++, Gokce M, Yetkin IM+, Baysal AI. Blink Reflex in Hypothyroidism. Endocrinologist. 2007 Jun;17(3):144–7.
4. Ladenson PW, Stakes JW, Ridgway EC. Reversible alteration of the visual evoked potential in hypothyroidism. Am J Med. 1984 Dec;77(6):1010–4.
5. Sachin Pawar VU. Usefulness of blink reflex in hypothyroid patients with or without polyneuropathy: a case control study. Indian J Physiol Pharmacol. 2014;58(1):56–60.
6. Michael J A. Electromyography in clinical practice. In: 5th ed. Elsevier 2005;
7. Karlikaya G. Nerve Conduction Studies, SEP and Blink Reflex Studies in Recently Diagnosed, Untreated Thyroid Disease Patients. J Neurol Sci Turk. 24(1):007–15.
8. Oflazo?lu B, Somay G, Us O, Surardamar A, Tanrida? T. Median sep and blink reflex in thyroid diseases. Electromyogr Clin Neurophysiol. 2006 Nov;46(6):365–70.
9. Kakked G, Bhatt N, Lakhani J, Prakash S. Electromyographic evaluation of blink reflex as a tool for early diagnosis of neurological dysfunction in patients of hypothyroidism. Ann Neurosci. 2013 Jul;20(3):95–8.
10. Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry. 2000 Jun;68(6):750–5.
11. Tonner DR, Schlechte JA. Neurologic complications of thyroid and parathyroid disease. Med Clin North Am. 1993 Jan;77(1):251–63.
12. Nemni R, Bottacchi E, Fazio R, Mamoli A, Corbo M, Camerlingo M, et al. Polyneuropathy in hypothyroidism: clinical, electrophysiological and morphological findings in four cases. J Neurol Neurosurg Psychiatry. 1987 Nov 1;50(11):1454–60.
13. Ozkardes A, Ozata M, Beyhan Z, Corakci A, Vural O, Yardim M, et al. Acute hypothyroidism leads to reversible alterations in central nervous system as revealed by somatosensory evoked potentials. Electroencephalogr Clin Neurophysiol. 1996 Nov;100(6):500–4.
|