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Results for “PERIPHERAL NERVE DISEASES”

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At least 73 records · Page 4Linked to original sources
PubMed2001

HIV neuropathy: insights in the pathology of HIV peripheral nerve disease.

HIV-associated neuropathies (HIV-N) have become the most frequent neurological disorder associated with HIV infection. The most common forms of HIV-N are the distal sensory polyneuropathy (DSP) and antiretroviral toxic neuropathies (ATN), disorders characterized mostly by sensory symptoms that include spontaneous or evoked pain that follow a subacute or chronic course. The main pathological features that characterize DSP and ATN include "dying back" axonal degeneration of long axons in distal regions, loss of unmyelinated fibers, and variable degree of macrophage infiltration in peripheral nerves and dorsal root ganglia. Marked activation of macrophages as well as the effect of pro-inflammatory cytokines appear to be the main immunopathogenic factors in DSP. Interference with DNA synthesis and mitochondrial abnormalities produced by nucleoside antiretrovirals have been hypothesized as pathogenic factors involved in ATN. The use of skin biopsy has become a useful tool in the evaluation of HIV-N. Reduction in fiber density, increased frequency of fiber varicosities and fiber fragmentation are prominent features of skin biopsies from patients with HIV-N. Other forms of HIV-N include acute or chronic inflammatory polyneuropathies, uncommon disorders that may ocur during seroconversion or early stages of HIV infection. Opportunisitic infections, mostly associated with cytomegalovirus or herpes zoster virus infection occur in late stages of AIDS and produce characteristic clinical features such as mononeuritis multiple or radiculopathies.

Antiretroviral Therapy, Highly Active↗
PubMed1990

The use of sensory action potentials in the diagnosis of peripheral nerve disease.

We review the different measurements that can be derived from recordings of compound sensory action potentials, and describe how less commonly measured aspects may be of use in clinical situations. In addition to the frequently obtained maximum conduction velocity and amplitude, minimum conduction velocity may be measured if near nerve electrodes and response averaging are used. Minimum conduction velocity is a sensitive measure of both axonal and demyelinating peripheral nerve pathology. Activity-dependent conduction is another aspect of sensory conduction that may provide additional information for the clinician. Refractory period of transmission has been used to diagnose subtle demyelinating lesions, as well as some axonal disorders. Supernormal period and the conduction of trains of stimuli may also be useful, although, at present, they remain predominantly research tools.

Action Potentials↗
PubMed1994

Diagnosis of patients with peripheral nerve disease.

Podiatrists have a unique opportunity to detect neuropathies at stages where specific treatment and measures to limit progression may be most beneficial. This article reviews neuropathic symptoms and signs that call for timely neurologic evaluation and intervention and outlines the essentials of a focused evaluation. The detailed clinical history and examination are still the mainstays for determining the specific diagnosis of most neuropathies and for distinguishing other neurologic disorders that may mimic neuropathies. Whenever the cause, severity, or very presence of a neuropathy remains uncertain, electromyography and nerve conduction studies performed by a well-trained physician experienced with neuromuscular diseases should be the mandatory next steps. Clinicians should expect electrophysiologic studies to define the specific pattern of neuropathy (fiber-length dependent versus multifocal) and the predominant pathologic process (axon loss versus demyelination), enabling them to restrict diagnostic tests to a rational, necessary, cost-effective, and productive minimum.

Diagnosis, Differential↗
PubMed2003

Autonomic dysfunction in peripheral nerve disease.

Autonomic neuropathies are inherited or acquired neuropathies in which autonomic nerve fibers are selectively or disproportionately affected. Generally, sympathetic and parasympathetic fibers are both affected but there are exceptions. Acquired cases can be autoimmune; due to diabetes, amyloidosis, drugs, or toxins; or idiopathic. Autoimmune autonomic neuropathy is often subacute, sometimes associated with a neoplasm, and associated with high titers of antibody to ganglionic nicotinic acetylcholine receptor in about half of the severe cases. The molecular basis of inherited autonomic neuropathies is better known, including recent identification of the loci and genes of hereditary sensory and autonomic neuropathies types I, III, and IV. The inherited amyloid neuropathies are due to mutations of three proteins: transthyretin, apolipoprotein A1, and gelsolin. Non-invasive autonomic testing complements clinical and electrophysiological characterization of the autonomic neuropathies.

Amyloid Neuropathies↗
PubMed1985

Baclofen as an analgesic in chronic peripheral nerve disease.

Baclofen has shown analgesic properties in a number of animal studies but has failed as a conventional analgesic in the human postoperative dental pain model. In order to test baclofen's analgesic properties in more chronic pain conditions, we selected postherpetic neuralgia and diabetic neuropathy pain as possible trial diseases for baclofen analgesia. 15 patients with postherpetic neuralgia and 10 with diabetic neuropathy pain were treated with baclofen. In the spinal postherpetic neuralgia group and diabetic neuropathy group, there was little evidence of analgesic effect. 6 of 7 patients with facial postherpetic neuralgia had a good response to baclofen during the 3-week trial. Baclofen does not appear to be a conventional analgesic.

Adult↗