Pavel Otruba1, Petr Kanovsky, Petr Hlustik. 1. Department of Neurology, Palacky Teaching and University Hospital Olomouc, Czech Republic. otruba.pavel@seznam.cz
Abstract
AIMS: 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.
AIMS: 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.
Authors: Toke de Koning Svendsen; Peter Nørregaard Hansen; Luis Alberto García Rodríguez; Lene Andersen; Jesper Hallas; Søren Hein Sindrup; David Gaist Journal: Br J Clin Pharmacol Date: 2017-05-11 Impact factor: 4.335