Treatment with statins and involvement of the peripheral nervous system: results of a prospective clinical and neurophysiological follow-up.
OBJECTIVE
To study the pathological changes in neurophysiological examination of lower-limb peripheral nerves in patients with long-term statin treatment.


METHODS
Forty-two patients (23 males, 19 females, mean age 51.9 and 52.3 years) with a definitive diagnosis of combined hyperlipidemia were studied. Other metabolic disorders or chronic ethanol abuse were excluded. Initial examinations included laboratory and neurophysiological measures (peroneal and tibial nerves: MNCV, CMAP, F-wave mean latency; superficial peroneal and sural nerve: SNCV, SNAP). Subsequently, treatment with simvastatin 20mg daily was initiated. Patients were followed for 24 months with examinations at 1, 6, 12 and 24 months after statin treatment initiation.


RESULTS
None of the patients reported subjective symptoms typical for polyneuropathy. In laboratory findings, there was no elevation of muscle enzymes. Nevertheless, electrophysiological examination of lower-limb peripheral nerves demonstrated statistically significant prolongation of F-wave mean latency on peroneal and tibial nerves (p < 0.0001, paired t-test). A control group of 50 patients with combined hyperlipidemia but no statin treatment showed no changes over the same time interval. The study demonstrated that long-term


CONCLUSIONS
The study demonstrated that long-term treatment with statins might cause a clinically silent but still electrophysiologically definite damage to peripheral nerves.
Otruba
Pavel
P
Department of Neurology, Palacky Teaching and University Hospital Olomouc, Czech Republic. otruba.pavel@seznam.cz
Kanovsky
Petr
P
Hlustik
Petr
P
D000200:Action Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy; D007866:Leg / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D010543:Peroneal Nerve / Q000187:drug effects; D011984:Sensory Receptor Cells / Q000187:drug effects; D013497:Sural Nerve / Q000187:drug effects
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors