The Hypertrophic Neuropathy of Acromegaly

Abstract

NEUROPATHIES in acromegaly are rarely observed despite the frequent appearance of these patients in neurological and neurosurgical clinics. Paresthesiae, on the other hand, are noted frequently and have been commented upon often.^1-3 These sensory symptoms are usually attributed to nerve entrapment by bony and soft tissue hypertrophy, for example, the carpal tunnel entrapment of the median nerve branches.^4-6 The slight symmetrical sensorimotor peripheral neuropathies occasionally found in acromegalics have been attributed to the mild diabetes mellitus so frequently associated with overproduction of growth hormone. In the literature one finds the occasional comment that hypertrophic tissue develops in the perineurium of the nerves of acromegalics but histological material is not available.^2,6 The following acromegalic patient recently examined and treated at the Neurological Institute of New York, Columbia Presbyterian Medical Center, exhibited a severe debilitating progressive peripheral neuropathy with interesting changes in perineurium and endoneurium found on nerve biopsy.