Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0152025 (polyneuropathy)
 7,862 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical and electrophysiological studies were performed on 250 patients with carpal tunnel syndrome. Acroparaesthesia was often referred to all digits (64%) and proximal pain was not uncommon (46%). The male patients as a group differed from the female in that nocturnal acroparaesthesia was less frequent and a causal of predisposing factor was identifiable in the majority (76%). The most common associated condition in the females was trigger finger (11%). An associated ulnar nerve lesion was rare. Delay in diagnosis was attributable to cultural factors or lack of awareness of the occurrence of diffuse acroparaesthesia and proximal pain in the syndrome. Sensory signs were commoner (85%) than motor (53%). The most useful clinical finding was digital sensory 'splitting' (ring finger) which was present in 58% of hands and clearly distinguished the condition from a radiculopathy, myelopathy or a diffuse polyneuropathy. In general, the diagnostic yield of any test depends on the duration of the disease. Of the various electrodiagnostic tests employing surface electrodes, the most sensitive was the comparison of the median (index finger) to ulnar (little finger) sensory amplitude. This was abnormal in 73% of hands and was found to be particularly useful in patients with a probable background of polyneuropathy or suspected cervical rib syndrome. Slowing of sensory conduction was demonstrable in 67% of hands, decreased sensory amplitude in 44% and prolonged motor latency 35 to 32%. A combination of the various electrodiagnostic tests yielded a positive result in 91%. Decompression resulted in complete recovery in 85% and some improvement in all the remaining patients. The outcome was adversely affected by the presence of several neurological deficits but apparently not by the presence of a coexisting disease.
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PMID:The carpal tunnel syndrome: a clinical and electrophysiological study of 250 patients. 61 9

In order to understand which neural elements are excited after percutaneous magnetic coil (MC) stimulation over the cervical vertebral column we have performed such study in 8 normal subjects and 4 patients. On moving the coil rostrocaudally up to 3 cm and horizontally up to 2 cm from the midline we found no change in the latencies of the compound muscle action potentials to biceps, deltoid, abductor pollicis brevis (APB) and abductor digiti minimi muscles indicating a fixed site of excitation of the spinal roots within the intervertebral foramina. F latencies to APB after stimulation of the median nerve at the wrist were always longer than the direct latencies obtained after cervical vertebral stimulation. The mean difference between indirect latency based on F technique and direct latency to APB was 0.45 msec which represented a distance of 2.7 cm distal to the anterior horn cells assuming a conduction velocity of 60 m/sec. MC stimulation in 2 patients suggested a diagnosis of cervical radiculopathy which was confirmed by imaging studies or operative findings. Both MC and needle root stimulation in one patient with diabetic brachial plexopathy and in another with diabetic polyneuropathy suggested that the needle stimulation occurred about 1.2-1.8 cm proximal to MC stimulation.
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PMID:Percutaneous magnetic coil stimulation of human cervical vertebral column: site of stimulation and clinical application. 171 22

We reported a patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), presenting localized radiculopathy as an initial symptom. The patient, a 38-year-old man, developed muscle atrophy of right shin and calf. In April 1988, neurological examination revealed decreased superficial sensation and muscle atrophy in right L-4 distribution. MRI of the lumbar spinal cord and myelography were negative. In April 1989, he was admitted to Chiba University Hospital. There were slight weakness of right ankle extension and flexion, muscle atrophy of bilateral shin and calf (that of the right leg was more marked), decreased sensation of polyneuropathy type in all modalities and generalized hypo- or a-reflexia. Nerve conduction study revealed marked prolongation of F response and focal conduction block in various site. The CSF was acellular and total protein was 177 mg/dl. Sural nerve biopsy disclosed decreased number of large myelinated fibers and scattered thin myelinated fibers. This case indicates that CIDP may present localized radiculopathy in early phase and is important to point out various mode of onset among CIDP.
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PMID:[Chronic inflammatory demyelinating polyradiculoneuropathy presenting localized radiculopathy as an initial symptom]. 189 72

Muscle hypertrophy is rare in denervating diseases. A patient with calf enlargement associated with L5-S1 radiculopathy and another with thenar, hypothenar, forearm and calf muscle hypertrophy in the course of chronic relapsing inflammatory demyelinating polyneuropathy are described. Gastrocnemius muscle biopsy revealed both type I and type II fibre hypertrophy in the former case and predominant type I fibre hypertrophy in the latter. Passive stretching and abnormal spontaneous muscular activity might have played a role in the origin of hypertrophy in both patients, but a satisfactory explanation for denervation hypertrophy has yet to be provided.
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PMID:Neurogenic muscle hypertrophy. Report of two cases. 276 Jun 47

Cortical somatosensory evoked potentials (SEPs) were studied by noninvasive magnetic stimulation at T-10, T-12, and L-5 vertebral levels and in mid-gluteus muscle and ankle in 27 normal subjects and 7 patients with neurological diseases. Cortical components P2 and N2 were recorded in all normal subjects. The mean peak latencies of P2 were 20.3 +/- 0.9 (standard deviation), 21.1 +/- 1.2, 23.5 +/- 1.4, 27.9 +/- 2.0, and 38.1 +/- 1.8 msec at the T-10, T-12, L-5, midgluteal and ankle sites of stimulation, respectively. No substantial difference in morphology of P2 and N2 was seen between magnetic and electrical stimulation at T-12. Amplitudes of P2 and N2 were maximal after magnetic stimulation at motor threshold. P2 and N2 may originate from the sensory cortex. P2 and N2 evoked by T-10 and T-12 stimulation were normal in peak latency and morphology in patients with polyneuropathy or polyradiculoneuropathy. Peak latencies of P2 and N2 evoked by T-10 and T-12 stimulation were significantly delayed in patients with myelopathy. The patients with radiculopathy showed a delayed peak latency and conduction time of P2 evoked by L-5 stimulation. Magnetic stimulation of spinal root is able to detect lesions of spinal cord noninvasively.
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PMID:Somatosensory potentials evoked by magnetic stimulation of lumbar roots, cauda equina, and leg nerves. 285 6

The presence of antibodies to human T-cell lymphoma/leukemia virus Type I (HTLV-I) has been associated with chronic progressive myelopathy. We attempted to isolate the virus from the blood and spinal fluid of patients with chronic progressive myelopathy and to define the clinical, radiologic, and electrophysiologic features of this disease. Ten of 13 patients from tropical countries and 2 of 8 from the United States had serum antibodies to HTLV-I. The virus was detected in cultures of peripheral-blood lymphocytes from three of seven patients by means of Southern blot hybridization. Using a sensitive in vitro enzymatic gene-amplification technique, we detected HTLV-I sequences in fresh peripheral-blood mononuclear cells of all of 11 patients tested who were positive for the antibody, and in cell cultures of the spinal fluid from 3 of the 11 tested. Magnetic resonance imaging of the cranium revealed periventricular lesions in the white matter of 3 of the 12 antibody-positive patients. Five of these patients had mild axonal sensorimotor polyneuropathy, and one had bilateral lumbar radiculopathy. Visual evoked potentials were abnormal in three seropositive patients, and brain-stem evoked responses were abnormal in two. The detection of the DNA and proteins of HTLV-I strengthens the proposition that this virus is involved in the pathogenesis of a subset of cases of chronic progressive myelopathy.
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PMID:Detection of human T-cell lymphoma/leukemia virus type I DNA and antigen in spinal fluid and blood of patients with chronic progressive myelopathy. 289

Three specific patterns of neurologic deficit were seen in a group of 52 patients with the idiopathic hypereosinophilic syndrome. Central nervous system dysfunction was seen in 7 patients (15%), 4 of whom had a distinctive encephalopathy characterized by behavioral disturbances and upper motor neuron signs. Peripheral neuropathy was found in 27 patients (52%), with a sensory polyneuropathy the commonest form (in 23 patients), although mononeuritis multiplex and radiculopathy were also seen. Central nervous system abnormalities from embolic disorders were seen in 6 patients (12%). Thus, a total of 65% of these patients had some neurologic dysfunction. Although the spectrum of neurologic disease is broad and includes very different manifestations, we conclude that distinct patterns of neurologic involvement are characteristic of this syndrome.
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PMID:Neurologic dysfunction in the idiopathic hypereosinophilic syndrome. 298 93

Involvement of the peripheral nervous system is very uncommon in the temporal arteritis-polymyalgia rheumatica syndrome. Three different presentations of the involvement can be recognized: mononeuropathy, polyneuropathy and brachial neuropathy--C-5 radiculopathy. We report 3 patients in whom peripheral nerve symptomatology dominated the clinical picture of the disease, and review 20 previously published cases.
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PMID:Involvement of the peripheral nervous system in temporal arteritis-polymyalgia rheumatica. Report of 3 cases and review of the literature. 303 77

Muscle enlargement and hypertrophy are rare findings in neurogenic lesions. The two in combination have been reported in cases of peripheral nerve lesions, polyneuropathy, and poliomyelitis. True and pseudo muscle hypertrophy are the two possible etiologies, whereas infiltration, stretch, or exercise of the muscle are the causative factors. We report two cases of unilateral calf enlargement, one occurring after surgery for S1 radiculopathy with associated cramping, and the other after poliomyelitis.
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PMID:Calf enlargement associated with neurologic disease: two uncommon cases. 333 40

The symptoms and signs which constitute the carpal tunnel syndrome (CTS) result from entrapment or compression of the median nerve within the carpal tunnel. Electrodiagnostic studies may objectively document the presence of median neuropathy within the carpal tunnel and help distinguish CTS from other disorders such as cervical radiculopathy, neurogenic thoracic outlet syndrome, proximal median nerve compression syndromes, and polyneuropathy which may either mimic or occasionally coexist with CTS. Recording median nerve responses with wrist and palm stimulation allows determination of the wrist segment conduction velocity which is a more sensitive nerve conduction parameter than wrist latency measurements. Electrodiagnostic testing permits estimation of severity and relative contribution of axonal versus demyelinative nerve injury. This information can provide prognostic information and help guide therapeutic decisions.
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PMID:AAEM case report #2: the carpal tunnel syndrome. 775 18


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