摘要:

Pain is a disabling symptom for many patients with peripheral neuropathy. The mechanisms responsible for neuropathic pain are not fully understood. Theories include ectopic discharges of damaged fibers and dorsal root ganglia, sensitization of nociceptors, central sensitization of dorsal horn neurons, loss of inhibitory neurons, and sprouting of afferent fibers after nerve injury into new regions of the nervous system. Several drugs have been effective in controlled clinical trials, but not all patients respond or tolerate the available agents.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The spectrum of hereditary neuropathies has evolved recently as a result of the exponential growth of genetic research. For the purpose of this review, we will use Charcot-Marie-Tooth (CMT), hereditary liability to pressure palsy (HNPP) and hereditary sensory and autonomic neuropathies (HSAN) to illustrate the current clinical and genetic approach to such neuropathies.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

We review the drugs that are known to induce muscle and/or nerve toxicity, describe the commonly encountered signs and symptoms, and discuss the mechanisms believed to be behind these iatrogenic effects. The diagnostic approach to patients suspected of having drug-induced neuromuscular disorders includes a comprehensive history and physical examination, proper blood workup, electrophysiological studies, and, if necessary, muscle or nerve biopsy. A lot of controversial issues continue to prevail when reviewing such a topic, secondary to the greatly variable levels of certainty for the association between drugs and their neuromuscular toxicity. We focus on drugs that are proven to cause these adverse effects, with less emphasis on the anecdotally suspected agents for which coincidence has not been eliminated.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

We report a 28-year-old man who presented with intestinal pseudo-obstruction as the initial manifestation of thymoma, myasthenia gravis, and dysautonomia. The patient's autoantibody profile was characteristic of this constellation of disorders, being positive for both muscle and ganglionic nicotinic acetylcholine receptor antibodies and striational antibody. Inflammatory cell infiltrates were found in the myenteric plexus of the stomach and small intestine. Review of 12 previously reported cases suggests that patients with both myasthenia gravis and dysautonomia in the context of thymoma respond poorly to therapy.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This is the report a case of diabetic muscle infarction (DMI) associated with multiple recurrences and a review of the literature on DMI from the first description in 1965 to the present. Specifically the review of the clinical, laboratory, and muscle histopathologic features of 86 reported cases of DMI.Patients with DMI usually present with acute or subacute focal lower extremity muscle pain or swelling. Elevations in the white blood cell count and erythrocyte sedimentation rate are common laboratory findings. Magnetic resonance imaging, a highly sensitive diagnostic test in DMI, shows increased T2-weighted signal and edema in affected muscles. Typical muscle histopathology includes muscle fiber necrosis and endomysial inflammation. Slow symptomatic improvement usually occurs over a period of 1 to 6 months. Conservative therapy and analgesics seem appropriate for most patients. Although self-limiting, DMI is often associated with recurrent muscle infarctions and multisystem diabetes-related complications. Diabetes-induced arteriosclerosis and microangiopathy are the suggested causes of DMI.It is concluded that DMI is an uncommon but probably underrecognized disorder causing focal muscle pain and swelling, usually of thigh or calf muscles, in patients with diabetes mellitus complicated by poorly controlled hyperglycemia and multiorgan complications.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Coexistence of myasthenia gravis with an immunologically mediated neuropathy syndrome is rare. We present a young male patient with a history of generalized muscle weakness and fatigue with electrophysiological evidence of both a motor neuron syndrome and a neuromuscular junction abnormality accompanied by pathologic evidence of denervation with muscle biopsy. Laboratory evidence for both acetylcholine receptor (AchR) antibodies and anti-asialo GM1 antibodies, both of high levels, was found. The patient's fatigue and weakness showed an objective response to pyridostigmine, prednisone, and immunoglobulin therapy over a period of 9 months.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Dropped head secondary to weakness of the neck extensors has been reported in a wide assortment of neuromuscular disorders. Infrequently, dropped head can be the first sign of disease. We describe two patients with dropped head as the presenting manifestation of mitochondrial myopathy. In both patients, serum lactate was elevated and muscle biopsy showed mitochondrial proliferation. Mitochondrial myopathy should be considered in the differential diagnosis of dropped head syndrome, particularly when other, more common causes such as myasthenia gravis, polymyositis, and amyotrophic lateral sclerosis have been excluded by appropriate laboratory and electrophysiological studies.

ISSN:1522-0443    

出版商:OVID    

年代:2003

数据来源: OVID