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Sensorimotor Polyneuropathy (sensorimotor + polyneuropathy)
Selected AbstractsPeripheral neuropathy associated with common variable immunodeficiencyEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2000A. J. Larner We report a patient with common variable immunodeficiency (CVID) who developed an axonal sensorimotor polyneuropathy, a hitherto unreported association to our knowledge. These conditions may be linked at the pathogenetic level, since some CVID patients are prone to the development of autoimmune disease. [source] Abstracts of the 8th Meeting of the Italian Peripheral Nerve Study Group: 57JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 1 2003D Cocito BACKGROUND: Since 1991, five sets of electrophysiological criteria for CIDP have been reported. However, until now, receiver operator characteristic (ROC), such as sensitivity and specificity, of only AAN criteria were investigated, showing a high specificity, but intermediate sensitivity. The application of these criteria may be useful in clinical trials, but is inadequate in clinical practice, since they preclude immunomodulating treatment in patients who do not meet them. OBJECTIVE: 1) to evaluate the ROC and predictive value of five different electrophysiological criteria for CIDP (AAN, INCAT, Rotta et al, Nicholas et al. and Saperstein et al.); 2) to identify the most informative electrophysiological features indicative of demyelination by mean of the likelihood ratio; 3) to determine, in our series of cases, a set of minimal electrophysiological criteria (albeit aspecific) enough sensitive for CIDP diagnosis. PATIENTS AND METHODS: 20 patients with sensorimotor polyneuropathy, progressive for at least 2 months, with weakness in least two limbs and documented improvement in strength in response to immunotherapy. Other potential causes were excluded, including diabetes and IgM paraproteinemia with or without anti-MAG reactivity. Twelve patients with axonal polyneuropathy associated with diabetes and 12 patients with amyotrophic lateral sclerosis were included as controls. Nerve conduction studies (NCS) were evaluated according to all five sets of NCS criteria and ROC was calculated. Likelihood ratio for CIDP was evaluated for each set of NCS criteria and for presence of each of the following features in different number of nerves: motor conduction velocities (MCV), conduction blocks/temporal dispersion, distal motor (DML) and F-wave latencies (FWL). MCV, DML and FWL were considered indicative of demyelination if decreased or increased as suggested by AAN criteria. Results will be discussed. [source] Medial dorsal superficial peroneal nerve studies in patients with polyneuropathy and normal sural responsesMUSCLE AND NERVE, Issue 3 2005Mark Kushnir MD Abstract We studied medial dorsal superficial peroneal (MDSP) nerves in 52 patients with clinical evidence of mild chronic sensorimotor polyneuropathy and normal sural nerve responses, in order to assess the diagnostic sensitivity and usefulness of MDSP nerve testing in electrodiagnostic practice. To determine the effect of age on MDSP nerve parameters, 98 normal subjects were also examined. Electrodiagnostic evaluation involved studies of motor nerve conduction in tibial, peroneal, and median nerves; sensory nerve conduction in sural, MDSP, median, and radial nerves; tibial and peroneal nerve F waves; H reflexes from the soleus muscles; and needle electromyography of gastrocnemius and abductor hallucis muscles. Among the patients, 49% had low-amplitude sensory responses in MDSP nerves and 57% had either slowing of sensory conduction velocity or no sensory responses on proximal stimulation. MDSP nerve amplitude, tibial nerve motor velocity, and H reflexes were the most sensitive for detection of mild chronic symmetrical axonal sensorimotor polyneuropathy. MDSP nerve testing should be included in the routine electrodiagnostic evaluation of patients with suspected polyneuropathy and normal sural nerve responses. Muscle Nerve, 2005 [source] Clinical variant of familial amyloid polyneuropathyMUSCLE AND NERVE, Issue 3 2002Dianna Quan MD Abstract Hereditary amyloidosis with early and prominent peripheral nerve involvement is often designated familial amyloid polyneuropathy (FAP). The abnormality usually lies in the transthyretin (TTR) gene. We describe a patient with a tyr77 TTR gene mutation who presented with sensorimotor polyneuropathy but no other systemic symptoms of amyloidosis. This is one of a few documented cases of the tyr77 mutation in North America. The clinical and electrophysiologic features of this unusual cause of sensorimotor polyneuropathy are discussed. © 2002 Wiley Periodicals, Inc. Muscle Nerve 26: 417,420, 2002 [source] Sensory nerve conduction deficit in experimental monoclonal gammopathy of undetermined significance (MGUS) neuropathyMUSCLE AND NERVE, Issue 6 2001Michael W. Lawlor BS Abstract An emerging body of evidence from in vitro studies and in vivo animal models supports a pathogenic role of antibodies in the development of peripheral neuropathy associated with monoclonal gammopathy of undetermined significance (MGUS). Although the assessment of motor and sensory nerve fiber function is of clinical importance, it is seldom applied experimentally. We describe the application of an electrophysiologic method for the evaluation of motor and sensory nerve fiber function using an experimental model of MGUS neuropathy. Supramaximal stimulation of the tibial nerve elicited an early motor response (M-wave, 1.7 ± 0.1 ms, n = 10) and a late sensory (H-reflex, 7.8 ± 0.1 ms, n = 10) response that was recorded from the hind foot of anesthetized rats. Intraneural injection of serum antibodies from a MGUS patient with sensorimotor polyneuropathy, but not from an age-matched control subject, produced a marked attenuation of the H-reflex (P < 0.01, n = 10) without affecting the M-wave. Light and electron microscopy of affected nerve showed myelinoaxonal degeneration with sparing of the smaller unmyelinated nerve fibers. The combined electrophysiologic and morphologic findings presented in this study are consistent with a selective sensory conduction deficit in MGUS neuropathy. Selective injury of afferent nerve fibers by this patient's serum antibodies may result from reactivity to neural antigens uniquely expressed by sensory neurons. © 2001 John Wiley & Sons, Inc. Muscle Nerve 24: 809,816, 2001 [source] Vasculitic neuropathy , electrodiagnostic findings and association with malignanciesACTA NEUROLOGICA SCANDINAVICA, Issue 6 2007S. A., ivkovi Background,,, Vasculitic neuropathies occur in the context of systemic disorders or in isolation. Histopathologic evaluation remains the gold standard for diagnosis, but certain electrodiagnostic findings may heighten suspicion of vasculitic neuropathy and improve the yield of nerve and muscle biopsy. Aim of the study,,, Description of electrodiagnostic patterns associated with vasculitic neuropathies, and a report of a possible association with malignancies. Methods,,, Retrospective review of medical records of patients with histopathologically proven vasculitic and non-vasculitic axonal neuropathies evaluated at the University of Pittsburgh Medical Center from November 1995 to November 2003. Results,,, The most distinctive electrodiagnostic patterns associated with vasculitic neuropathy were mononeuritis multiplex (27.5% vs 4% in controls; P = 0.003) and axonal sensorimotor polyneuropathy with side-to-side amplitude asymmetry (50% vs 32%, P > 0.05). Additionally, six patients (15% vs 2%; P = 0.034) developed various malignancies within 2 years of onset of vasculitic neuropathy. Conclusions,,, While generalized polyneuropathy was the most common presentation of nerve vasculitis, our study affirms side-to-side amplitude asymmetry and mononeuritis multiplex as the most distinctive electrodiagnostic features. The frequent occurrence of malignancies suggests a possible association with the vasculitic neuropathy and warrants additional investigation. [source] | ||||||||||