title: The pathology of median neuropathy in acromegaly.
abstract: BACKGROUND
  Median neuropathy is commonly associated with acromegaly, although its pathology is uncertain.
  
  
  OBJECTIVE
  To study the pathology of median neuropathy in acromegaly by using magnetic resonance imaging (MRI).
  
  
  METHODS
  Case series.
  
  
  METHODS
  Outpatient clinic and MRI unit.
  
  
  METHODS
  Nine patients with acromegaly, four of whom had clinical symptoms of neuropathy.
  
  
  METHODS
  At presentation and 6 months after treatment, median nerve size, its signal intensity, and the volume of the carpal tunnel contents were measured.
  
  
  RESULTS
  At presentation, patients with symptoms of neuropathy had increased nerve size and signal intensity compared with asymptomatic patients, but the two groups did not differ in volume of carpal tunnel contents. These measures improved with treatment of acromegaly in symptomatic patients; asymptomatic patients experienced no change or worsening.
  
  
  CONCLUSIONS
  The predominant pathology of median neuropathy in acromegaly seems to be increased edema of the median nerve within the carpal tunnel rather than extrinsic compression from increased volume of the carpal tunnel contents.
authors.affiliation: Department of Endocrinology, St. Bartholomew's Hospital, London, United Kingdom.
authors.forename: P J
authors.initials: PJ
authors.lastname: Jenkins
authors.forename: S A
authors.initials: SA
authors.lastname: Sohaib
authors.forename: S
authors.initials: S
authors.lastname: Akker
authors.forename: R R
authors.initials: RR
authors.lastname: Phillips
authors.forename: K
authors.initials: K
authors.lastname: Spillane
authors.forename: J A
authors.initials: JA
authors.lastname: Wass
authors.forename: J P
authors.initials: JP
authors.lastname: Monson
authors.forename: A B
authors.initials: AB
authors.lastname: Grossman
authors.forename: G M
authors.initials: GM
authors.lastname: Besser
authors.forename: R H
authors.initials: RH
authors.lastname: Reznek
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D000328:Adult; D004487:Edema / Q000473:pathology; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D020423:Median Neuropathy / Q000473:pathology* / Q000503:physiopathology; D009431:Neural Conduction
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I