Neurological complications of primary hypothyroidism of various origin
Kharkiv National Medical University, Kharkiv, Ukraine
Abstract. The purpose of the work was to determine pathogenetic metabolic bioenergetic regularities of forming neurological syndromes at primary hypothyroidism (PH) of various origins. The study involved 154 patients with PH against a background of autoimmune thyroiditis (AIT) and 127 patients with PH after thyroidectomy aged 36−59. The investigation included clinical neurological, instrumental, biochemical and statistical study. The clinical biochemical investigation demonstrated that PH against a background of AIT was more frequently accompanied by combined variants, i.e. encephalopolyneuropathy (55.8%) and encephalomyelopolyneuropathy (25.3%) and more pronounced increase in the level of atherogenic fractions of lipid metabolism and hormone−mediator dysbalance of the sympathoadrenal system with the shift towards activation of its mediator link. In patients with post−operative PH, encephalopathy (45.7%) and neuromuscular syndromes (46.5%) were noted more frequently with more pronounced activation of oxidant antioxidant system and shift of the sympathoadrenal system towards activation of the hormonal link. Disorders in energy production at PH did not depend on the disease origin but correlated with severity of thyroid dysbalance and metabolic dysorders. The revealed peculiarities of forming neurological signs at PH of various origin should be taken into account when administering the treatment.
Key words: primary hypothyroidism, autoimmune thyroidism, thyroidectomy, neurological complications, metabolic disorders.