Abstract 27: Neuropathy in primary hypothyroidism and response to thyroxine replacement

Background: Entrapment neuropathy and sensorimotor polyneuropathy has been described as a manifestation of hypothyroidism in many studies. Only few studies are available in Indian population to know the extent of neuropathies in hypothyroid patient and effect of thyroxine replacement on these abnormalities. Aims and Objectives: To study the extent and pattern of peripheral nerve involvement in hypothyroid (subclinical and overt) patients and the response to optimal thyroid hormone replacement in them. Methods: Consecutive patients with primary hypothyroidism were clinically and electrophysiologically evaluated for peripheral nerve dysfunction at baseline and after achieving euthyroid status. Results: A total of 61 patients, were studied (Mean age 39.2 yrs, Range 19 - 55 yrs, Mean TSH 22.32 ±15.6 IU/ml). Baseline clinical examination was abnormal in 13 (21.3%) and electrophysiology was abnormal in 21 (34.4%). Among these, 6 (29%) had demyelination, 8 (38%) axonal neuropathy and 07 (33%) entrapment neuropathy. After optimal thyroxine replacement, 14 (67%) showed complete recovery. While 8 (72.7%) out of 11 with sensory axonal neuropathy showed significant improvement, all 04 patients with motor neuropathy showed significant improvement. One patient with demyelinating neuropathy did not show any improvement. Out of 7 patients with CTS, 5 (71.4%) showed improvement after thyroxine replacement Conclusion: Subclinical peripheral nerve involvement is frequent in primary hypothyroidism and most cases responds well to optimum thyroxine replacement.