Bulletin of the Russian Military Medical AcademyBulletin of the Russian Military Medical Academy1682-73922687-1424Eco-Vector1228110.17816/brmma12281Research ArticleClinical and pathogenic features of entrapment neuropathy in patient’s hands with acromegalyNikishchencovaA Sannaniki@inbox.ruZhulevS N-ZhulevN M-KhalimovYu Sh-ZagrebelnayaO A-KarpenkoM N-AlekseevaT M-TrofimovaT N-ShiryaevaE V-ZhulevV S-1509201820212012301052019Copyright © 2018, Nikishchencova A.S., Zhulev S.N., Zhulev N.M., Khalimov Y.S., Zagrebelnaya O.A., Karpenko M.N., Alekseeva T.M., Trofimova T.N., Shiryaeva E.V., Zhulev V.S.2018For specification of entrapment neuropathies pathogenesis in patients with acromegaly clinical and electroneurophysiological trial of the nerveswere conducted. It was determined that motor disorders in patients with incomplete remission of an acromegalia were more often than in patients with full remission. A significant difference between the frequency of occurrence of sensitive disturbances in patients with incomplete and full remission of acromegalia was not revealed. Expression of disturbances of the majority of electroneurophysiological indicators was more appreciable in patients with incomplete remission. In patients with incomplete remission the moderated and expressed disturbances prevailed, and patients from full remission had mild disturbances. The neurologic symptomatology of tunnel neuropathies and electroneuromyography disturbances were more expressed in group with incomplete remission. Conservative therapy of tunnel neuropathies was more effective in patients with full remission of acromegaly. It was revealed that the durability of acromegalia and accompanying pathology of a patient also influences expression of neurologic symptomatology and effect of the treatment. The lesser the durability of acromegalia, the better treatment results of neuropathies. The data obtained with a magnetic and resonant tomography on growth existence round a tendon of a flexor, regional growth of a bone trapeze and augmentation of transversal section of a median nerve and as signal strength change from it allow to specify a pathophysiology of tunnel neuropathies in acromegalia. The combined use of an electroneuromyography and a magnetic and resonant tomography possesses high informational content in diagnostics of tunnel neuropathies. These methods allow giving an objective assessment of changes of neuromuscular changes in patients with a syndrome of the carpal channel with acromegalia. Specification of a pathogenesis of tunnel neuropathies allows carrying out correction of agents and treatment methods in patients with acromegalia, thus reaching good results of treatment in short terms.tunnel neuropathyacromegalyelectroneuromyographymedian nerveulnar nervemagnetic and resonant tomographysyndrome of the carpal channelsomatotropic hormone of a pituitary bodyinsulinoid factor of body height-1туннельная невропатияакромегалияэлектронейромиографиясрединный нервлоктевой нервсиндром запястного каналасоматотропный гормон гипофизаинсулиноподобный фактор роста-1[Дедов, И.И. Эндокринология: национальное руководсво. Кра- ткое издание / И.И. Дедов, Г.А. Мельниченко. - М.:ГЭОТАР- медиа, 2013. - 752 с.][Жулёв, С.Н. Невропатии (приобретенные) /С.Н. Жулёв, Н.М. Жулёв, А.С. Никищенкова.- СПб.: Группа МИД, 2016. - 444 с.][Команцев, В.Н. Алгоритмы клинико-электронейромиографи- ческой диагностики повреждений периферических нервов для неврологов и миографистов: учебное пособие / В.Н. Команцев [и др.]. - СПб.: Система, 2007. - 64 с.][Пронин, В.С. Диагностические и прогностические факторы, определяющие особенности клинического течения и так- тику лечения акромегалии: дис. … д-ра мед. наук / В.С. Пронин. -М., 2011. - 300 с.][Colao, A.Systemic complications of acromegaly: epidemiology, pathogenesis and management / A. Colao [et al.] // J. Endocr. Rev.,2004. - № 25. - P. 102-152.][Cutt, S. Cubital tunnel syndrome /S. Cutt // Postgrad. Med. Journal. - 2007. -№83. - P. 28-31.][Dinn, J.J.Schwann cell dysfunction in acromegaly / J. J.Dinn // J. Clin Endocrinol Metab. - 1970. - № 31. - P. 140-143.][Jenkins, P. J.The pathology of media neuropathy in acromegaly / P.J. Jenkins [et al.] // Ann. Intern Med. - 2000. - № 133. - P. 197-201.][Кunze, N. M. Investigation of local deformation of the median nerve in magnetic resonance images of the carpal tunnel / N.M. Kunze // Iowa research online. - 2010. - 120 p.][Preston, D.C. Electromyography and neuromuscular disorders. Appendix. Nerve conduction studies: normal adult values / D.C. Preston, B.E. Shapiro. Newton: Butterworth-Heinemann, 2nd ed., 2005. - P. 561-564.]