Publication: İleri yaş grubunda elektrofizyolojik incelemeler
Abstract
Elektrodiagnostik inceleme gerektiren nöromüsküler hastalık spektrumunun ilerleyen yaşla birlikte değişkenlik gösterip göstermediğini incelemek amacıyla elektrodiagnoz laboratuvarımıza son 6 yıl içinde başvuran 65 yaş ve üstü bireylere yapılan nörofizyolojik incelemeler retrospekif olarak incelendi. Bu süre içinde başvuran toplam 3076 olgunun 250'si (%8,12) 65 yaş ve üstünde olup 96'sı erkek (%38,4) ve 154'ü kadın (%61,6) idi. Çalışmaya alınan olguların yaş ortalaması 69,2±4,2 (65-86) yıl idi. Yaşlı olgulara en sık konulan tanılar sırasıyla tuzak nöropatiler ve bunlardan da karpal tünel sendromu (%26,4), periferik fasial paralizi (%23,2), çeşitli periferik sinir lezyonları (%12,4), polinöropati (%11,6) ve radikülopati (%5,6) idi. İki olguda incelemeler motor nöron hastalığını destekler nitelikteydi. Olguların %16,4'ünde elektrodiagnostik incelemeler normal bulundu. Yaşlı olgularda en sık rastlanan elektrodiagnostik tanı olan karpal tünel sendromu oldukça yüksek oranda bilateral idi (%72,7). Periferik fasial sinir lezyonu tanısı ile gönderilen olguların çoğunda erken dönemde belirgin rejenerasyon bulgusuna rastlandı. İlginç nokta olguların %70,7'sinde sol fasial sinir tutulumu olmasıydı. Yaşlı bireylerle ilgili diğer bir dikkat çeken bulgu da iyi bilinmesine ve alınan tüm önlemlere rağmen 5 olguda enjeksiyona bağlı siyatik sinir nöropatisinin görülmesi olmuştur. İnceleme yapılan yıllara göre değerlendirildiğinde de 6 yıl içinde, başlangıca göre giderek daha yüksek oranda yaşlının elektrodiagnostik inceleme için gönderildiği gözlendi.
We retrospectively evaluated the electrodiagnostic investigations in the elderly age group (aged 65 years or older) in the last 6 years in our electrodiagnostic laboratory to determine whether the neuromuscular disease spectrum changes with the advancing age. During this period 3076 patients admitted to our laboratory, 96 (38,4%) male and 154 (61,6%) female, a total of 250 (8,12%) were 65 years or older and they were included in the study. The mean age was 69,2±4,2 (65-86) years. The most common diagnoses were entrapment neuropathies and carpal tunnel syndrome (26,4%), peripheral facial nerve paralysis (23,2%), various peripheral nerve lesions (12,4%), polyneuropathy (11,6%), and radiculopathies (5,6%), respectively. Electrodiagnostic findings suggestive for motor neuron disease in 2 patients. Normal results were encountered in 16,4% of the elderly people. Carpal tunnel syndrome was the most common electrophysiologic diagnosis, and in the majority of our elderly patients with carpal tunnel syndrome, the condition was bilateral (72,7%). In patients with peripheral facial nerve paralysis we found a higher and earlier rate of regeneration. But in this patient group, interestingly, 70,7% of the lesions affected the left facial nerve. Another important finding in elderly patients was the presence of sciatic nerve paralysis in 5 cases, inspite of increased awareness and all the measures against the condition. When the distribution according to admittance years are evaluated, we found that an increasing rate of admission to our laboratory were seen during the 6 years.
We retrospectively evaluated the electrodiagnostic investigations in the elderly age group (aged 65 years or older) in the last 6 years in our electrodiagnostic laboratory to determine whether the neuromuscular disease spectrum changes with the advancing age. During this period 3076 patients admitted to our laboratory, 96 (38,4%) male and 154 (61,6%) female, a total of 250 (8,12%) were 65 years or older and they were included in the study. The mean age was 69,2±4,2 (65-86) years. The most common diagnoses were entrapment neuropathies and carpal tunnel syndrome (26,4%), peripheral facial nerve paralysis (23,2%), various peripheral nerve lesions (12,4%), polyneuropathy (11,6%), and radiculopathies (5,6%), respectively. Electrodiagnostic findings suggestive for motor neuron disease in 2 patients. Normal results were encountered in 16,4% of the elderly people. Carpal tunnel syndrome was the most common electrophysiologic diagnosis, and in the majority of our elderly patients with carpal tunnel syndrome, the condition was bilateral (72,7%). In patients with peripheral facial nerve paralysis we found a higher and earlier rate of regeneration. But in this patient group, interestingly, 70,7% of the lesions affected the left facial nerve. Another important finding in elderly patients was the presence of sciatic nerve paralysis in 5 cases, inspite of increased awareness and all the measures against the condition. When the distribution according to admittance years are evaluated, we found that an increasing rate of admission to our laboratory were seen during the 6 years.