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Nerve Dysfunction (nerve + dysfunction)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Neurology	23%
Diabetes	17%
Pathology	11%

Selected Abstracts

A 27-YEAR-OLD WOMAN WITH CRANIAL NERVE DYSFUNCTION

BRAIN PATHOLOGY, Issue 3 2007
Andrei Koerbel MD
No abstract is available for this article. [source]

Objective Facial Motion Analysis in Patients With Facial Nerve Dysfunction

THE LARYNGOSCOPE, Issue 7 2002
Christopher J. Linstrom MD
Abstract Objectives/Hypothesis To objectively measure facial motion at various facial landmarks using a video-computer interactive system. Study Design Clinical, prospective, non-randomized. Methods A video-computer interactive system, The Peak Motus Motion Measurement System, was used to study linear displacement at preselected facial landmarks in the normal and abnormal face. Subjects with normal facial function (n = 34) and patients with abnormal facial function (n = 26) from various etiologies were studied. The sites studied were marked with reflective beads. Of a larger repertoire of expressions, two expressions (eyes closed and closed-lip smile) were studied in all subjects. The percent asymmetry in facial displacement between the sides of the face was calculated. The sensitivity of this measurement to facial dysfunction was evaluated. The presence of synkinesis was examined by quantifying the displacement at facial sites that were remote to the sites primarily involved in a given facial expression. Test,retest reliability of the percent asymmetry measurement was evaluated with the paired t test. Results The video-computer interactive approach used accurately detected and quantified gross and subtle changes in facial function. The sensitivity of the percent asymmetry measurement was 95% (both expressions) for patients with apparent facial dysfunction (House-Brackmann rating >I/VI). In patients with facial nerve dysfunction, displacement on the presumably normal side was significantly excessive in 27% to 35%, depending on the expression. With this interactive computer-video system, synkinesis was detected in 58% of the pathologic subjects during the eyes closed or closed-lip smile expressions. The paired t test indicated strong test,retest reliability (r = 0.73,0.99) of the percent asymmetry measurement. Conclusions The present report indicates that this approach to the assessment of facial motion is sensitive to facial dysfunction. This computer-video interactive system is able to quantify synkinesis. A grading system for the magnitude of synkinesis, based on the magnitude of the displacement at remote facial sites, is proposed. The common occurrence of excessive facial motion on the presumably normal side of affected individuals indicates that patients with facial paralysis often overcompensate by exaggerating the normal side in an effort to move the affected side. This system is of value in the objective measurement of normal facial function and may prove a useful tool to quantify the outcomes of various medical and surgical treatments for facial nerve dysfunction. [source]

Diabetic neuropathy and oxidative stress

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 4 2006
Rodica Pop-Busui
Abstract This review will focus on the impact of hyperglycemia-induced oxidative stress in the development of diabetes-related neural dysfunction. Oxidative stress occurs when the balance between the production of reactive oxygen species (ROS) and the ability of cells or tissues to detoxify the free radicals produced during metabolic activity is tilted in the favor of the former. Although hyperglycemia plays a key role in inducing oxidative stress in the diabetic nerve, the contribution of other factors, such as endoneurial hypoxia, transition metal imbalances, and hyperlipidemia have been also suggested. The possible sources for the overproduction of ROS in diabetes are widespread and include enzymatic pathways, auto-oxidation of glucose, and mitochondrial superoxide production. Increase in oxidative stress has clearly been shown to contribute to the pathology of neural and vascular dysfunction in diabetes. Potential therapies for preventing increased oxidative stress in diabetic nerve dysfunction will be discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source]

The value of the Rydel-Seiffer tuning fork as a predictor of diabetic polyneuropathy compared with a neurothesiometer

DIABETIC MEDICINE, Issue 6 2004
T. Kästenbauer
Abstract Aims The aim of the study was to investigate the predictive value of the Rydel-Seiffer tuning fork for detecting diabetic neuropathy and to compare it with an electronic neurothesiometer. Methods In 2022 consecutive diabetic subjects, peripheral polyneuropathy was diagnosed by vibration perception threshold (VPT) at the tip of both great toes using a 128-Hz tuning fork and a neurothesiometer, by simple bedside tests and by the presence of neuropathic symptoms. These evaluations were further combined to diagnose peripheral nerve dysfunction (abnormal bedside tests) and symptomatic neuropathy. VPT was also measured in 175 non-diabetic control subjects to define normal values. Results VPT was normal in 1917 subjects and abnormal in 105 (5.2%) patients when measured by the tuning fork. Patients with an abnormal vibration test were significantly (P < 0.0001) older than subjects with a normal vibration sense, while diabetes duration and HbA1c of the former were also significantly elevated. The same was true for the percentages of an abnormal 10-g monofilament test (66.7% vs. 7.2%, P < 0.0001) and a missing Achilles' tendon reflex (68.6% vs. 24.8%, P < 0.0001). Finally, the VPT measured by the neurothesiometer was 2.5 times higher in patients with an abnormal tuning fork test (32.0 ± 9.8 vs. 12.5 ± 6.4 V, P < 0.0001). The plot of the difference of both methods against their mean yielded a good agreement of the two VPT measurements, and the tuning fork had a high sensitivity and positive predictive value for the diagnosis of abnormal bedside tests and for symptomatic neuropathy. Conclusion The tuning fork reliably detected peripheral neuropathy in comparison with the neurothesiometer. A tuning fork is a useful screening test for diabetic neuropathy. [source]

Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus

DIABETIC MEDICINE, Issue 3 2000
B. -L.
Summary Aims Recent studies have indicated that proinsulin C-peptide shows specific binding to cell membrane binding sites and may exert biological effects when administered to patients with Type 1 diabetes mellitus. This study was undertaken to determine if combined treatment with C-peptide and insulin might reduce the level of microalbuminuria in patients with Type 1 diabetes and incipient nephropathy. Methods Twenty-one normotensive patients with microalbuminuria were studied for 6 months in a double-blind, randomized, cross-over design. The patients received s.c. injections of either human C-peptide (600 nmol/24 h) or placebo plus their regular insulin regimen for 3 months. Results Glycaemic control improved slightly during the study and to a similar extent in both treatment groups. Blood pressure was unaltered throughout the study. During the C-peptide treatment period, urinary albumin excretion decreased progressively on average from 58 ,g/min (basal) to 34 ,g/min (3 months, P < 0.01) and it tended to increase, but not significantly so, during the placebo period. The difference between the two treatment periods was statistically significant (P < 0.01). In the 12 patients with signs of autonomic neuropathy prior to the study, respiratory heart rate variability increased by 21 ± 9% (P < 0.05) during treatment with C-peptide but was unaltered during placebo. Thermal thresholds were significantly improved during C-peptide treatment in comparison to placebo (n = 6, P < 0.05). Conclusion These results indicate that combined treatment with C-peptide and insulin for 3 months may improve renal function by diminishing urinary albumin excretion and ameliorate autonomic and sensory nerve dysfunction in patients with Type 1 diabetes mellitus. [source]

The effect of bilateral glossopharyngeal nerve anaesthesia on swallowing in horses

EQUINE VETERINARY JOURNAL, Issue 1 2005
E. A. KLEBE
Summary Reasons for performing study: Dysfunction of the glossopharyngeal nerve has been implicated as a cause of dysphagia in horses. However, recent studies have indicated that this is not the case. Objectives: To determine whether bilateral glossopharyngeal nerve anaesthesia would cause dysphagia in horses or result in measurable alterations in the timing, function, or sequence of swallowing. Methods: Swallowing was evaluated in 6 normal horses with and without bilateral glossopharyngeal nerve anaesthesia. Swallowing dynamics were assessed subjectively and objectively based on time from prehension of food until swallowing, number of tongue movements until initiation of swallowing, depth of bolus at the base of the tongue prior to initiation of swallow and evidence of tracheal aspiration using fluoroscopy and endoscopy. Results: There was no evidence of aspiration or dysphagia in horses before or after bilateral glossopharyngeal nerve block. No observed or measured differences in swallowing sequence or function could be detected in blocked compared to unblocked horses. However, there was a trend in blocked horses for the number of tongue pushes and the time to swallowing to be increased. Conclusions: Glossopharyngeal nerve function may not be essential for normal swallowing function in otherwise healthy horses. Potential relevance: Clinically, normal swallowing is not an appropriate test of glossopharyngeal nerve function and dysphagic horses should not be assumed to have glossopharyngeal nerve dysfunction. [source]

High prevalence of vasomotor reflex impairment in newly diagnosed leprosy patients

EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2005
X. Illarramendi
Abstract Background, Initial nerve damage in leprosy occurs in small myelinated and unmyelinated nerve fibers. Early detection of leprosy in the peripheral nervous system is challenging as extensive nerve damage may take place before clinical signs of leprosy become apparent. Patients and methods, In order to determine the prevalence of, and factors associated with, peripheral autonomic nerve dysfunction in newly diagnosed leprosy patients, 76 Brazilian patients were evaluated prior to treatment. Skin vasomotor reflex was tested by means of laser Doppler velocimetry. Blood perfusion and reflex vasoconstriction following an inspiratory gasp were registered on the second and fifth fingers. Results, Vasomotor reflex was impaired in at least one finger in 33/76 (43%) patients. The fifth fingers were more frequently impaired and suffered more frequent bilateral alterations than the second fingers. Multivariate regression analysis showed that leprosy reaction (adjusted odds ratio = 8·11, 95% confidence interval: 1·4,48·2) was associated with overall impaired vasomotor reflex (average of the four fingers). In addition, palmar erythrocyanosis and an abnormal upper limb sensory score were associated with vasomotor reflex impairment in the second fingers, whereas anti-phenolic glycolipid-I antibodies, ulnar somatic neuropathy and a low finger skin temperature were associated with impairment in the fifth fingers. Conclusions, A high prevalence of peripheral autonomic dysfunction as measured by laser Doppler velocimetry was observed in newly diagnosed leprosy patients, which is clinically evident late in the disease. Autonomic nerve lesion was more frequent than somatic lesions and was strongly related to the immune-inflammatory reaction against M. leprae. [source]

Combined endovascular and surgical treatment of head and neck paragangliomas,A team approach,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2002
Mark S. Persky MD
Abstract Background Paragangliomas are highly vascular tumors of neural crest origin that involve the walls of blood vessels or specific nerves within the head and neck. They may be multicentric, and they are rarely malignant. Surgery is the preferred treatment, and these tumors frequently extend to the skull base. There has been controversy concerning the role of preoperative angiography and embolization of these tumors and the benefits that these procedures offer in the evaluation and management of paragangliomas. Methods Forty-seven patients with 53 paragangliomas were treated from the period of 1990,2000. Initial evaluation usually included CT and/or MRI. All patients underwent bilateral carotid angiography, embolization of the tumor nidus, and cerebral angiography to define the patency of the circle of Willis. Carotid occlusion studies were performed with the patient under neuroleptic anesthesia when indicated. The tumors were excised within 48 hours of embolization. Results Carotid body tumors represented the most common paraganglioma, accounting for 28 tumors (53%). All patients underwent angiography and embolization with six patients (13%), demonstrating complications (three of these patients had embolized tumor involving the affected nerves). Cerebral angiography was performed in 28 patients, and 5 of these patients underwent and tolerated carotid occlusion studies. The range of mean blood loss according to tumor type was 450 to 517 mL. Postoperative cranial nerve dysfunction depended on the tumor type resected. Carotid body tumor surgery frequently required sympathetic chain resection (21%), with jugular and vagal paraganglioma removal frequently resulting in lower cranial nerve resection. These patients required various modes of postoperative rehabilitation, especially vocal cord medialization and swallowing therapy. Conclusions The combined endovascular and surgical treatment of paragangliomas is acceptably safe and effective for treating these highly vascular neoplasms. Adequate resection may often require sacrifice of one or more cranial nerves, and appropriate rehabilitation is important in the treatment regimen. © 2002 Wiley Periodicals, Inc. [source]

Use of the sensory nerve stimulator to accelerate healing of a venous leg ulcer with sensory nerve dysfunction: a case study

INTERNATIONAL WOUND JOURNAL, Issue 3 2005
Article first published online: 7 SEP 200
Utilisation d'un stimulateur nerveux sensitif pour accélerer la cicatrisation des ulcères veineux avec dysfonctionnement nerveux sentitif: à propos d'un cas Un nouveau traitement utilisant la stimulation nerveuse sensitive (International Patent Appliction Number PCT/AU2004/001079 , nerve dysfunction and tissue healing"(Khalil Z) a été développé dans notre laboratoire de physiologie vasculaire. Ce traitemeent a montré une amélioration de la fonction nerveuse sensitive et les déficiences en cicatrisation associées chez des personnes agées par rapport à des personnes jeunes. Un homme de 82 ans présentant un ulcère de jambe petit mais persistant depuis 18 mois, en dépit d'un traitement approprié en pansements et en contention., a été vu dans un service specialisé en traitement des plaies. Les functions sensitives et microvasculaires etaient évaluées avec beaucoup de details gràce à l'utilisation de techniques de laboratoire de physiologie vasculaire, et il a bénéficié d'un traitement par stimulation en complément d'un traitement conventionnel. Sa plaie a cicatrisé après 4 semaines. Nous rapportons ce cas ici. Avant traitement par stimulation nerveuse, la sensation cutanée, le flux sanguin microcirculatoire et la tension d'oxygène ont été trouvées diminuées près de l'ulcère en comparaison avec le membre oppose non ulcéré. Après traitement, la tension d'oxygène et la flux sanguin microcirculatoire étaient améliorés. Ce cas apporte une preuve supplémentaire que le traitement par stimulation nerveuse sensitive dans des conditions bien définies améliore la cicatrisation. L'observation d'une amélioration de la fonction nerveuse sensitive supporte la nition qu'une amélioration de la cicatrisation est liée à une amélioration de la fonction nerveuse. Anwendung eines sensiblen Nervenstimulationsgerätes zur beschleunigten Wundheilung eines venösen Beinulcus mit begleitender neurologischer Dysfunktion: eine Fallstudie Eine neue Therapieform zur Stimulation der Nervensensibilität wurde in den eigenen Laboratorien entwickelt. Diese Behandlungsform zeigte eine Verbesserung der insbesondere bei älteren Patienten vorliegenden eingeschränkten Nervenfunktion und der damit verbundenen verzögerten Wundheilung. Wir berichten über den Fall eines 82 jährigen Patienten mit einem kleinen, über 18 Monaten persistierenden venösen Ulkus am Unterschenkel trotz Anwendung verschiedener Wundauflagen und einer begleitenden Kompressionsbehandlung. In unserem Labor wurden unter Anwendung vaskulärerer und physiologsicher Messungen die Sensibilität und die mikrovaskuläre Funktion erfasst und eine Nervenstimulationstherapie in Verbindung mit Wundauflagen und Kompressionsbehandlung durchgeführt. Die Wundheilung war nach 4 Wochen abgeschlossen. Vor der Nervenstimulationstherapie war die Hautsensibilität, der mikrovaskuläre Blutfluss sowie der Sauerstoffdruck im Gewebe im Vergleich zur gesunden Gegenseite vermindert. Nach der Therapie zeigten sich alle drei Parameter verbessert. Dieser Fall stellt einen weiteren Beweis dar, dass eine zusätzliche Nervenstimulation zu den etablierten Behandlungsstrategien die Wundheilung positiv beeinflusst. Die Beobachtung dass sich die sensible Nervenfunktion verbessert hat lässt zusätzlich den Schluss zu, dass eine Optimierung der Wundheilung auch durch eine verbesserte Nervenfunktion erreicht wird. Impiego della stimolazione di nervi sensoriali per accelerare la guarigione di ulcere venose della gamba con disfunzione dei nervi sensoriali: studio di un caso Nel nostro laboratorio di fisiologia vascolare è stata sviluppata una nuova terapia che utilizza la stimolazione dei nervi sensoriali (brevetto internazionale di applicazione numero: PCT/AU2004/001079: riparazione del tessuto e della funzione del nervo (Khalil, Z). Questo trattamento ha mostrato di migliorare la carente funzione dei nervi sensoriali e la ridotta riparazione tessutale di ferite in persone anziane se paragonate ai livelli di guarigione di persone giovani.. Un uomo di 82 anni con una piccola ma persistente ulcera delle gambe presente da 18 mesi, nonostante un apparente ed appropriato trattamento con medicazioni e compressione, è stato visitato in un servizio specialistico per la cura delle ferite. Le funzioni sensoriali del paziente e la microcircolazione sono state monitorizzate in grande dettaglio utilizzando le tecniche del laboratorio di fisiologia vascolare, ed è stata fornita la terapia di stimolazione dei nervi sensoriali in aggiunta alla terapia convenzionale.. La sua ferita è guarita in quattro settimane. Noi riportiamo qui un caso. Prima del trattamento con stimolazione dei nervi, sono state riscontrate ridotte la sensibilità cutanea, il flusso ematico microcircolatorio e la tensione di ossigeno vicino alla lesione ulcerativa, se comparate con la sede controlaterale non ulcerata. Dopo la terapia, la tensione di ossigeno ed il flusso microcircolatorio sono migliorati. Questo caso fornisce una ulteriore evidenza che la terapia con stimolazione del sensorio migliora la riparazione tessutale di ferite seguendo determinati parametri. L'osservazione di una migliore funzione sensoriale fornisce supporto per la nozione che una migliore riparazione tessutale è mediata da una migliore funzionalità dei nervi. Uso del estimulador nervioso sensitivo para acelerar la cicatrización de una úlcera vascular venosa con disfunción nerviosa sensitiva: estudio de un caso En nuestro laboratorio de fisiología vascular se ha desarrollado un nuevo tratamiento basado en la estimulación nerviosa sensitiva [Número de Solicitud de Patente Internacional: PCT/AU2004/001079: ,Función nerviosa y cicatrización tisular"(Khalil, Z)]. Se ha comprobado que este tratamiento mejora la función nerviosa sensitiva deficiente y la subsiguiente curación deficiente de heridas en personas de edad avanzada hasta alcanzar los niveles observados en personas jóvenes. En un servicio de tratamiento de heridas especializado se visitó a un hombre de 82 años con una úlcera vascular venosa pequeña, pero persistente durante 18 meses a pesar de la aplicación de apósitos aparentemente apropiados y tratamiento compresivo. Se evaluaron muy por debajo las funciones sensitiva y microvascular del paciente por medio de técnicas de laboratorio de fisiología vascular y se le aplicó tratamiento de estimulación nerviosa sensitiva además de tratamiento convencional. Su herida curó al cabo de 4 semanas. En este artículo describimos el caso. Antes de proceder al tratamiento de estimulación nerviosa se comprobó que la sensibilidad cutánea, el flujo sanguíneo microvascular y la concentración de oxígeno estaban reducidos en la proximidad de la úlcera en comparación con la pierna contralateral, no ulcerada. Después del tratamiento, la concentración de oxígeno y el flujo sanguíneo microvascular habían mejorado. Este caso proporciona pruebas adicionales de que el tratamiento de estimulación nerviosa sensitiva, con los parámetros especificados, mejora la curación de las heridas. La observación de la mejoría de la función nerviosa sensitiva respalda el concepto de que la mediación de una cicatrización más óptima reside en la mejoría de la función nerviosa. Användandet av känselnerv stimulator för att påskynda läkning av venösa bensår med känselnerv dysfunktion: en fallstudie En ny terapi som använder känselnerv stimulering [Internationellt Patent Ansökningsnummer PCT/AU2004/001079: ,nervfunktion och vävnadsläkning'(Khalil, Z)] har utvecklats i vårt laboratorium för vaskulär fysiologi. Denna behandling har visat sig förbättra försämrad känselnervfunktion och ansluten nedsatt sårläkning hos äldre personer till nivåer iakttagna hos yngre personer. En 82-årig man med ett litet venöst bensår som emellertid fortbestått i 18 månader, trots klart tillbörliga sårförband och kompressionsterapi, sågs på en specialist sårvårdsmottagning. Patientens känslofunktion och mikrovskulära funktion undersöktes ingående med hjälp av vaskulärfysiologiska laboratorie tekniker, och han erhöll känselnerv stimuleringsterapi samt konventionell terapi. Hans sår läktes efter 4 veckor. Vi rapporterar detta fall här. Jämfört med det andra sårfria benet iakttogs i området runt såret nedsatt känsla i huden, nedsatt mikrovaskulärt blodflöde och syre tryck före insättandet av nervstimuleringsterapi. Efter terapin hade syretrycket och mikrovaskulära blodflödet förbättrats. Denna fallstudie utgör ett ytterligare bevis för att känselnerv stimuleringsterapi förbättrar sårläkning i de parameter som stipulerats. Observationen att känselnervfunktionen förbättrades utgör ett stöd för uppfattningen att förbättrad nervfunktion åstadkommer förbättrad sårläkning. [source]

Temporohyoid Osteoarthropathy in 33 Horses (1993,2000)

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2002
Anne M. Walker
A retrospective study of the medical records of 33 horses was performed to determine the clinical and diagnostic abnormalities associated with temporohyoid osteoarthropathy. Data collected from medical records included signalment, presenting complaints, history, physical examination findings, laboratory data, results of diagnostic imaging studies, and treatments. Follow-up information was obtained from a review of case records; by telephone conversation with the owner, veterinarian, or trainer; or by both methods. Of 33 horses with temporohyoid osteoarthropathy, 29 presented with facial nerve (cranial nerve VII) deficits and 23 presented with vestibulocochlear nerve (cranial nerve VIII) deficits. Guttural pouch endoscopy was more reliable than radiography for diagnosis. Of horses with unilateral clinical signs, 22.6% actually had bilateral disease. Magnetic resonance imaging and computed tomography identified the lesions in all horses in which these tests were performed. Of 30 horses for which follow-up information was obtained, 20 (67%) were alive. Eight horses were euthanized and 1 died because of problems associated with temporohyoid osteoarthropathy. Nineteen of 20 surviving horses (95%) were considered by the owner or trainer to be suitable for athletic use. Twelve surviving horses (60%) had residual facial nerve deficits; 11 horses (55%) had residual vestibulocochlear nerve deficits. Horses with temporohyoid osteoarthropathy have a fair prognosis for return to some type of athletic function, but there is risk of acute death. The majority of horses would be expected to have some residual cranial nerve dysfunction, and it could take a year or longer for maximal improvement to occur. [source]

Can antiglycolipid antibodies present in HIV-infected individuals induce immune demyelination?

NEUROPATHOLOGY, Issue 4 2000
Steven Petratos
Of the eight clinically defined neuropathies associated with HIV infection, there is compelling evidence that acute and chronic inflammatory demyelinating polyneuropathy (IDPN) have an autoimmune pathogenesis. Many non-HIV infected individuals who suffer from sensorymotor nerve dysfunction have autoimmune indicators. The immunopathogenesis of demyelination must involve neuritogenic components in myelin. The various antigens suspected to play a role in HIV-seronegative IDPN include (i) P2 protein; (ii) sulfatide (GalS); (iii) various gangliosides (especially GM1); (iv) galactocerebroside (GalC); and (v) glycoproteins or glycolipids with the carbohydrate epitope glucuronyl-3-sulfate. These glycoproteins or glycolipids may be individually targeted, or an immune attack may be raised against a combination of any of these epitopes. The glycolipids, however, especially GalS, have recently evoked much interest as mediators of immune events underlying both non-HIV and HIV-associated demyelinating neuropathies. The present review outlines the recent research findings of antiglycolipid antibodies present in HIV-infected patients with and without peripheral nerve dysfunction, in an attempt to arrive at some consensus as to whether these antibodies may play a role in the immunopathogenesis of HIV-associated inflammatory demyelinating polyneuropathy. [source]

Objective Facial Motion Analysis in Patients With Facial Nerve Dysfunction

C-peptide prevents nociceptive sensory neuropathy in type 1 diabetes

ANNALS OF NEUROLOGY, Issue 6 2004
Hideki Kamiya MD
We examined the effects of C-peptide replacement on unmyelinated fiber function in the hind paw, sural nerve C-fiber morphometry, sciatic nerve neurotrophins, and the expression of neurotrophic receptors and content of neuropeptides in dorsal root ganglia in type 1 diabetic BB/Wor-rats. C-peptide replacement from onset of diabetes had no effect on hyperglycemia, but it significantly prevented progressive thermal hyperalgesia and prevented C-fiber atrophy, degeneration, and loss. These findings were associated with preventive effects on impaired availability of nerve growth factor and neurotrophin 3 in the sciatic nerve and significant prevention of perturbed expression of insulin, insulin growth factor,1, nerve growth factor, and neurotrophin 3 receptors in dorsal root ganglion cells. These beneficial effects translated into prevention of the decreased content of dorsal root ganglia nociceptive peptides such as substance P and calcitonin gene,related peptide. From these findings we conclude that replacement of insulinomimetic C-peptide prevents abnormalities of neurotrophins, their receptors, and nociceptive neuropeptides in type 1 BB/Wor-rats, resulting in the prevention of C-fiber pathology and nociceptive sensory nerve dysfunction. The data indicate that perturbed insulin/C-peptide action plays an important pathogenetic role in nociceptive sensory neuropathy and that C-peptide replacement may be of benefit in treating painful diabetic neuropathy in insulin-deficient diabetic conditions. Ann Neurol 2004 [source]

ANALYSIS OF COMPLICATIONS FOLLOWING SURGICAL TREATMENT OF BENIGN PAROTID DISEASE,

ANZ JOURNAL OF SURGERY, Issue 3 2008
S. A. Reza Nouraei
Background: The objective of the study was to study the incidence of, and risk factors for developing complications following parotidectomy for benign disease, to improve preoperative patient counselling and better inform future surgical management. Methods: An 11-year retrospective review of 162 parotidectomies for benign disease, collecting and analysing data about presentation, investigations, surgical treatment, postoperative facial nerve function, Frey's syndrome and other surgical complications. Results: The mean age at presentation was 58 years. The commonest pathology was benign pleomorphic adenoma (43%), followed by Warthin's tumour (30%) and chronic sialadenitis (22%). Sialadenitis was a significant risk factor for facial nerve palsy and increased the incidence of salivary fistulas. Parotid duct ligation increased the risk of nerve palsy in the distribution of zygomatic and buccal branches. Operations for Warthin's tumour were associated with an increased risk of dysfunction of the cervical branch of the nerve. Half the patients had intraoperative facial nerve stimulation and this did not influence the likelihood of facial paresis. The recovery of facial nerve function showed a biphasic distribution, with 90% of patients having normal function within 12 months, followed by a slower recovery rate for up to 2 years. Conclusion: The incidence of postoperative complications was influenced by the pathology, with inflammatory lesions significantly increasing the risk of facial nerve dysfunction and other complications, but also by variations in surgical practice, such as parotid duct ligation. Overall, the incidence of permanent facial paralysis was less than 2%, but temporary nerve palsy was common at 40%, with most patients regaining normal function within 1 year of the operation. [source]

Serum somatostatin in early-stage Parkinson's disease

ACTA NEUROLOGICA SCANDINAVICA, Issue 4 2010
M. Shiraishi
Shiraishi M, Kobayashi T, Watanabe H, Kamo T, Hasegawa Y. Serum somatostatin in early-stage Parkinson's disease. Acta Neurol Scand: 2010: 121: 225,229. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To compare levels of plasma digestive hormones in patients with and without nausea or vomiting during initial treatment of early-stage Parkinson's disease (PD). Methods,,, This was a 3-week, open-label, randomized study of treatment with an antiparkinson drug in untreated PD patients. We measured the levels of plasma digestive hormones before (baseline) and 3 weeks after administration of an antiparkinson drug. Results,,, Mean value of serum somatostatin at baseline was significantly increased in PD patients compared with the control group (P < 0.01). Serum somatostatin levels were significantly increased after treatment in subjects who experienced nausea or vomiting (P < 0.01). However, significant increase in serum somatostatin levels after treatment was not observed in PD patients without nausea or vomitting. Conclusion,,, Serum somatostatin in early-stage PD patients before treatment was increased compared with healthy subjects. The nausea and vomiting induced by antiparkinson drugs may be related to uncontrolled somatostatin secretion through central vagus nerve dysfunction. [source]

Sural nerve biopsy may predict future nerve dysfunction

ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009
S. Thrainsdottir
Objective,,, Sural nerve pathology in peripheral neuropathy shows correlation with clinical findings and neurophysiological tests. The aim was to investigate progression of nerve dysfunction over time in relation to a baseline nerve biopsy. Methods,,, Baseline myelinated nerve fiber density (MNFD) was assessed in sural nerve biopsies from 10 men with type 2 diabetes, 10 with impaired and 10 with normal glucose tolerance. Nerve conduction and quantitative perception thresholds were estimated at baseline and follow-up (7,10 years later). Results,,, Subjects with low MNFD (,,4700 fibers/mm2) showed decline of peroneal amplitude (P < 0.02) and conduction velocity (P < 0.04), as well as median nerve sensory amplitude (P < 0.05) and motor conduction velocity (P < 0.04) from baseline to follow-up. In linear regression analyses, diabetes influenced decline of nerve conduction. MNFD correlated negatively with body mass index (r = ,0.469; P < 0.02). Conclusion,,, Low MNFD may predict progression of neurophysiological dysfunction and links obesity to myelinated nerve fiber loss. [source]