Reversible alteration of Nerve Conduction Velocity in Iron Deficient Anemic Patients in Response to Treatment

Aim: Evaluation of nerve conduction in adult patients of iron deficiency anemia and to study the response to treatment.

Study Design: Prospective randomized control study

Place and Duration of Study: Department of Medicine and Department of Physiology, PGIMS Rohtak

Introduction: Iron deficiency anemia is associated with central and peripheral nervous system disturbances. Iron is an essential component of brain growth, myelination, nerve impulse conduction, protein synthesis, hormone production, fundamental aspects of cellular energy metabolism and is involved in neurotransmitter synthesis including serotonin, norepinephrine and dopamine. Hence, its deficiency adversely affects motor performance, mental development as well as cognitive and behavioral functions. Since myelination is concerned with conduction in nerve fibers, iron deficiency potentially impairs neuronal transmission and leads to functional neurodeficit like dysfunction in the peripheral nervous system such as paresthetic complaints.

Method: Nerve conduction was recorded using RMS EMG EP MK2 machine in 30 newly diagnosed patients of iron deficiency anemia with haemoglobin less than 10.9-4 g/dl between 18-50 years of age who were followed up after 3 months of treatment and compared with 30 age and sex matched controls.

Results: An increase in distal latencies and a decrease in amplitude and nerve conduction velocities of motor and sensory component of all the nerves was seen in IDA patients as compared to the control groups which was reversible with iron replacement therapy.

Conclusion: Altered values of nerve conduction parameters indicates peripheral neuropathy in IDA individuals with or without polyneuropathy. Thus, nerve conduction study provides an objective method for monitoring the function of PNS, especially the clinically silent peripheral nerve compromise in patients of iron deficiency anemia before and after iron replacement therapy. Thus NCS is a non-invasive test for early diagnosis and therefore early treatment to prevent complications.