gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Electrophysiological changes of median nerve conduction following pituitary surgery for acromegaly

Elektrophysiologischer Verlauf der N. medianus-Leitfunktion nach Hypophysenchirurgie bei Akromegalie

Meeting Abstract

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  • corresponding author T. N. Witt - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, München
  • S. Zausinger - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, München
  • E. Uhl - Neurochirurgische Klinik, Ludwig-Maximilians-Universität, München

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP115

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0383.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Witt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective

Acromegaly is often associated with compression of the median nerve leading to signs and symptoms of the carpal tunnel syndrome. Aim of the current study was to measure electrophysiological changes before and after resection of the growth hormone producing pituitary adenoma.

Methods

Fifteen consecutively treated patients with acromegaly were clinically examined before, 1 week, 3 weeks, 3 months and one year after transsphenoidal removal of a growth hormone producing adenoma. Patients were monitored endocrinologically and by MR imaging of the pituitary. In addition, electrophysiology of the median nerve including distal motor (dml) and sensory latency (dsl) and sensory nerve conduction velocity (SNCV).

Results

Mean IGF-1 was 789±196 ng/ml before surgery and decreased to 298±128 ng/ml 6 weeks after surgery. Seven patients had clinical signs of median nerve compression. 4/30 hands had already had surgery for carpal tunnel syndrome before the diagnosis of acromegaly. Electrophysiology was pathological in 9 patients. Electrophysiological parameters showed a tendency to improve within one week after surgery already. Dml measured 6.8±6.8ms preoperatively and decreased to 4.9±2.6ms three months after surgery (p<0.01). The same improvement was found for the dsl. The parameter decreased significantly from 4.5±0.8ms to 4.1±0.7ms three months after surgery (p<0.001). SNCV was 40.3±8.7m/s (normal >45m/s) and continuously increased within 3 months to 45.2±8.3m/s (p<0.001). No further improvement of these parameters was seen after one year.

Conclusions

Serial measurements of several motor and sensory conduction parameters of the median nerve in acromegaly before and after surgery showed a continuous improvement within three months after removal of the adenoma. No further improvement was seen after one year. We conclude that control investigations for monitoring of median nerve function in acromegaly is best at three months after surgery. Sensory parameters seem to be superior to motor parameters.