Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Monoclonal gammopathies are frequently associated with peripheral neuropathies of which clinical, electrophysiological, pathological and possibly pathogenetical aspects are heterogeneous. Nevertheless some clinico-biological entities, which account for the majority of cases, have been recently recognized: 1) The IgM neuropathy is a chronic demyelinating sensori-motor polyneuropathy with tremor and ataxia as prominent features. It can be either associated with MGUS or Waldenstrom macroglobulinemia. The light chain of the gammopathy is kappa in a majority of cases. Numerous reports have demonstrated specific antibody activities supported by the M-protein and directed against various peripheral nerve antigens, usually myelin components such as the myelin associated glycoprotein (MAG). The ultrastructural evidence of widely spaced myelin is suggestive of the diagnosis but is not consistent. Treatment directed towards the gammopathy is occasionally associated with improvement of the symptoms. 2) The neuropathy of the osteosclerotic myelomas and solitary plasmacytomas present as a chronic sensori-motor polyradiculoneuropathy with conspicuous demyelination and may be associated with one or more of the systemic clinical features of the Crow-Fukase or POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin changes). The POEMS syndrome may also be associated with "benign" monoclonal or even polyclonal dysproteinemias. The M-proteins are almost all IgG or IgA with lambda light chains. There are some relations between POEMS syndrome and Castleman's disease. The pathogenesis of both disorders remains obscure. Treatment is most favorable in case of solitary plasmacytomas, which may be completely removed. 3) The neuropathy observed in patients with primary AL amyloidosis or amylosis associated with malignant plasma-cell dyscrasias is rare. Sensory deficit and autonomic dysfunction are related to a prominent involvement of small myelinated and unmyelinated fibers. A clinical and/or electro-physiological carpal tunnel syndrome is frequent. In a majority of cases the light chain of the M-protein is lambda. Amyloid deposits are observed on nerve biopsy. Treatment is inefficient. 4) The neuropathy associated with cryoglobulinemias may be asymmetric, painful, cryosensitive and associated with cutaneous purpura and neuromuscular vasculitis. In fact, in a majority of cases the symptoms are less suggestive raising the problem of an incidental laboratory finding. 5) A motoneuron disease-like syndrome may develop in patients with various types of monoclonal gammopathies.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Dysglobulinemic neuropathies]. 284 76

Two hundred and sixty-two patients with carpal tunnel syndrome (CTS) were analyzed retrospectively. Results showed that middle- and older-age women were more apt to have CTS than men, and that the dominant hand was more frequently affected. Hormonal changes, repetitive and forceful movements, awkward positions of hand and wrist, and other factors may be associated with CTS. Typical clinical manifestations include pain and paresthesia in the median nerve territory, worsening at night or in the early morning, and being relieved by shaking the hand. Although the patients may localize the discomfort beyond the territory, sensory changes are variable and not entirely reliable. Conduction abnormalities often appeared selectively in the median nerve distal to the wrist in CTS. If the patient who is clinically suggestive of CTS shows normal conduction with conventional methods, palmar stimulation and inching technique is recommended. The diagnosis of CTS requires confirmation of illness history, symptoms and signs with objective electrodiagnostic tests.
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PMID:Carpal tunnel syndrome: etiological, clinical and electrophysiological aspects of 262 cases. 764 14

Sarcoidosis is a systemic disease that may affect the musculoskeletal system. An association between carpal tunnel syndrome (CTS) and sarcoidosis has not been demonstrated. Consecutive patients from the sarcoidosis clinic at our institution were questioned about history and symptoms of carpal tunnel syndrome: hand numbness and nocturnal paresthesias with relief of symptoms by shaking of the hands (flick sign). A physical exam was performed to evaluate for Tinel's and Phalen's signs. A comparison of the presence of arthritis, prednisone treatment, spirometry, and number of organs involved with sarcoidosis was made in patients with a history or clinical findings of CTS versus those without. Eighty-nine patients were evaluated. Thirty-five patients (39%) had nocturnal paresthesias with a positive flick sign. Fourteen patients (16%) had physical findings of CTS. A history of CTS was present in 14 (16%) of the patients, four of which were documented by EMG. There was no significant difference between the frequency of prednisone treatment in patients with or without CTS history, nocturnal paresthesias, or Phalen's sign. There were significantly fewer patients with a positive Tinel's sign who were receiving prednisone. There was a trend toward an increased frequency of wrist arthritis in patients with a history or clinical findings of CTS. There was no significant difference in disease severity, assessed by spirometry or organ involvement, when comparing sarcoidosis patients with or without a history or clinical findings of CTS. Thirty-nine (44%) had symptoms and/or signs of CTS. Even when we adjusted our sarcoidosis population for other factors associated with CTS, the prevalence of symptoms and signs of CTS was much higher in our patient population than in studies of the general population. Our findings suggest that CTS is common in sarcoidosis.
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PMID:Carpal tunnel syndrome in sarcoidosis. 1158 2

Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder. The clinical features of CTS are variable, but usually include pain and paresthesia in the thumb, first two fingers, and the radial-half of the ring finger. Paresthesia and sensory deficits might involve the entire palm area in some cases. Pain frequently radiate proximally into the forearm, and occasionally to the shoulder. Many patients experience pain at night and are awakened by abnormal sensations. Shaking hand relief the symptom. The two classic tests for nerve compression at the wrist are the Tinel test and the Phalen maneuver, which diagnostic value is limited. Golden standard for the diagnosis is the combination of the clinical findings and the electrophysiological study. Routine median nerve conduction study is valuable. Prolonged terminal latency of motor or sensory nerve would be found in most CTS hands. If the routine study showed equivocal, more sensitive methods are needed. Those include segmental sensory conduction study across the carpal tunnel by median stimulation at midpalm, a comparison of median and ulnar sensory nerve latencies at ring finger and a comparison of median and radial sensory nerve latencies at thumb. A difference between the median motor latency to the second lumbrical and the ulnar motor latency to the interossei muscles has also diagnostic value in some cases. In addition, inching method can localized the compression site. Using these techniques, the diagnosis of CTS would become more reliable.
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PMID:[Clinical and electrophysiological findings in carpal tunnel syndrome]. 1804 99

One hundred and fifty-two patients with suspected carpal tunnel syndrome (CTS) completed a questionnaire, including questions about the location of paraesthesia, nocturnal pain, the effect of shaking the hand, relief by use of a wrist splint and impairment of manual dexterity. A score was derived from the symptom questionnaire and clinical signs including Tinel's test, Phalen's test, and altered sensation. Nerve conduction studies (NCS) were done in 91 cases in which the diagnosis of CTS was in doubt. A threshold questionnaire score was selected as indicating a diagnosis of CTS. Sixty-six patients were predicted to have CTS. When compared with the results of NCS this score had a specificity of 67% and sensitivity of 82%. Ninety-five patients underwent carpal tunnel release. A management model has been developed based on the questionnaire score for symptoms and signs.
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PMID:Assessment of a diagnostic questionnaire and protocol for management of carpal tunnel syndrome. 1958 78

Background: Carpal tunnel syndrome is a common neuropathy in the hand which presented with pain and paresthesia in the hands and the wrists. The aim of our study was evaluated clinical symptoms of patients with different severity of CTS. Methods: This study is a cross-sectional study was performed on 40 patients referred to Emam khomeyni Hospital in Tehran from 2017 to late 2019 with symptoms of CTS and have been diagnosed with a definite diagnosis. Results: A positive significant correlation was between severity of CTS and age, and reverse significant correlation was between severity of CTS with duration of symptoms. There were significant relationships between severity of CTS and shaking or ringing the hands symptoms, weakness or atrophy of the flexion test and reverse phalen test (P < 0.05). Conclusion: Clinical symptoms of CTS can be diagnosing different severity of disease, so considering of symptoms can plays a predominant role in the diagnosis of the disease.
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PMID:Clinical presentation of carpal tunnel syndrome with different severity: a cross sectional study. 3149 81