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[Anterior pituitary function in the vegetative state].

H Yoshimoto, T Uozumi

    Neurologia Medico-Chirurgica
    |June 1, 1989
    PubMed
    Summary

    Anterior pituitary function is frequently impaired in patients with a vegetative state, often worsening over time. This study highlights the prevalence of hormonal deficits in these patients.

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    Area of Science:

    • Endocrinology
    • Neurology
    • Reproductive Medicine

    Background:

    • The vegetative state presents complex challenges in patient management.
    • Anterior pituitary dysfunction can significantly impact overall health and recovery potential.

    Purpose of the Study:

    • To investigate the prevalence and patterns of anterior pituitary hormone secretion in patients with a vegetative state.
    • To identify clinical factors associated with anterior pituitary dysfunction in this population.

    Main Methods:

    • Radioimmunoassays were used to measure growth hormone, cortisol, luteinizing hormone, follicle stimulating hormone, thyroid stimulating hormone, and prolactin levels.
    • Insulin tolerance testing, luteinizing hormone-releasing hormone, and thyroid-releasing hormone administration were employed.
    • Impairment rate was calculated and statistically analyzed against clinical factors including disease etiology, duration, brain atrophy, and EEG grade.

    Main Results:

    • All 33 patients exhibited impaired anterior pituitary hormone secretion, with 52% showing severe impairment.
    • Growth hormone and luteinizing hormone secretion were most frequently abnormal (70% and 67%, respectively).
    • Higher impairment rates correlated significantly with ruptured cerebral aneurysms, primary coma, severe brain atrophy, and abnormal EEGs.

    Conclusions:

    • Anterior pituitary dysfunction is a common finding in patients with a vegetative state.
    • Hormonal deficits often occur early and may progress with longer durations of illness.
    • Clinical factors such as etiology and brain imaging findings are associated with the severity of pituitary impairment.

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