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Query: UMLS:C0152025 (polyneuropathy)
 7,862 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. The sensory action potentials of the tibial nerve at the medial malleolus were studied by averaging in 51 patients with chronic renal failure treated by hemodialysis. Vibratory sense was also tested quantitatively on the dorsum of the foot with a pallesthesiometer. 2. Good correlation was found between sensory tibial nerve potentials and vibration sense in subclinical as well as in clinical uremic polyneuropathy. A biphasic potential correlated with unaffected vibration sense in 18 out of 23 patients, and impaired vibratory sense with a polyphasic response in 20 of 28 patients. Maximal nerve conduction of sensory fibres was faster (mean 37.4 m/sec) in cases with normal vibratory sense, but slower (mean 31.3 m/sec), when vibratory sense was impaired. Furthermore there was a correlation between the threshold of vibratory perception and sensory nerve conduction. 3. Sensory function, tested with conventional methods, was impaired only 5 times in 28 patients with altered vibratory perception. 4. The earlier impairment, especially of the vibratory sense, may be explained by the following neurophysiological mechanisms: a) Because of the polyphasic prolonged response of the sensory potentials, no rhythmical groups of impulses reach the central nervous system, but only a continual stream of small peaks arrives, so that vibration perception does not develop. b) A multiplication of the frequency of discharges caused by alternating firing of different sensory fibres is impossible due to the reduction of the number of axons. c) The prolongation of the relatively refractory period due to demyelinization of the surviving fibres prevents the transmission of frequent impulses. 5. Alterations of the sensory action potentials of the tibial nerve, as well as of vibratory perception tested quantitatively, are earlier signs of uremic polyneuropathy than the prolonged motor nerve conduction velocity. Since not all patients give accurate information when tests of vibratory sense are performed both methods should be applied. Physiological polyphasia of sensory action potentials and diminishing vibration perception in advanced age must be taken into account.
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PMID:[Correlation between sensory action potentials and vibratory perception in uremic polyneuropathy (author's transl)]. 5 8

In a series of patients with chronic renal failure managed conservatively, the rise in the plasma-myo-inositol (myoinositol) concentration has been found to be related to depression of sural-nerve conduction velocity. There was no correlation with motor-nerve conduction velocity in the peroneal nerve, or with either of these variables in a series of patients receiving chronic haemodialysis. Despite the negative correlation with sural-nerve conduction velocity, there was no correlation between the plasma-myoinositol concentration and the presence of peripheral neuropathy as assessed clinically. It is concluded that hypermyoinositolaemia may depress nerve conduction velocity, but there is no evidence that it is responsible for the development of uraemic polyneuropathy.
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PMID:Plasma-myoinositol concentrations in uraemic neuropathy. 6 75

The involvement of peripheral motor and sensory nerve, at least on a subclinical level, is nearly constant event with chronic renal failure. The study of the motor and sensory propagation velocity indicates that a widespread functional lesion of the axon with a peripheral point of attack and secondary demyelination, may be the basic pathogenetic event of uremic polyneuropathy. Prolonged hemodialytic treatment is substantially unable to influence the evolution of uremic polyneuropathy. The electrophysiological follow-up study of the peripheral nerve does not seem to be an index of adequate dialysis.
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PMID:Effects of hemodialytic treatment on uremic polyneuropathy. A clinical and electrophysiological follow-up study. 7 58

The changes in the peripheral nerve function of three patients with chronic renal failure who were treated over a period of 1-1/2 to 2 years by hemofiltration have been analyzed in the form of a longitudinal study by quantitative measurements of vibratory perception threshold and nerve conduction velocity. Changes in vibratory perception threshold were measured in six patients both before and after treatment. Despite increased values of creatinine and BUN, an improvement in the peripheral nerve function of all patients undergoing hemofiltration could be observed, although vibratory perception and nerve conduction velocity did not return to normal. All of the vibratory perception threshold measurements made directly after hemofiltration showed an improved vibratory perception in comparison to the original values. A comparison of the measurement methods showed a good correlation and clearly indicated the advantage of vibratory perception threshold measurements as a means for the routine diagnosis of nephrogenic polyneuropathy.
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PMID:Changes in peripheral nerve function with long-term hemofiltration treatment. 20 67

In 12 patients with chronic renal failure who received kidney transplants from either cadavers (6) or related living donors (6), rapid improvement in median sensory and motor nerve conduction velocities (NCVs) was observed within a few days after transplantation. The postoperative improvement in median sensory NCV was found to bear a statistically significant negative correlation with creatinine and myo-inositol concentrations. We suggest that metabolic phenomena are responsible for the rapid improvement in median sensory NCV following renal transplantation. The close relationship between myo-inositol and the median sensory NCV following transplantation suggests that elevated plasma myo-inositol concentrations may be related to nerve conduction abnormalities in uremic polyneuropathy.
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PMID:Rapid improvement in nerve conduction velocity following renal transplantation. 36 77

The following parameters have been examined in twenty-one patients suffering from chronic renal failure (creatinine level between 4.5 and 18.8 mg/100 ml serum): maximum motor nerve conduction of the peroneal nerve, amplitude of the compound muscle action potential of the extensor digitorum brevis muscle, serum creatiine, total protein, serum globulins, serum albumins, alkali reserve, time of increase of serum creatinine above 4 mg/100 ml up to time of determination of the maximum motor nerve conduction, daily urinary excretion, mean blood pressure, (p less than 0.01) was found between maximum motor nerve conduction, as well as amplitude of the compound muscle action potential, and the serum albumin level only. Decreased levels of serum albumin, is correlated with diminished nerve conduction and a lower amplitude. The relationship between the electrophysiological data and serum albumin levels maybe explained on the basis of progression of a pre-existing polyneuropathy due to additional dietary malnutrition. A different interpretation is the assumption of an inactivation of neurotoxin on binding by albumins. A decrease in the albumin level would, therefore, result in an increased amount of unbound toxic agent. The values of the maximum motor nerve conduction were between 16 m/sec and 51 m/sec (mean value 42.2 m/sec), pointing to a polyneuropathy of primary axonal type rather that to primary demyelinization. The amplitudes of the compound muscle action potentials were not greatly reduced and thus the uraemic polyneuropathy seems to be of mixed type. In uraemic polyneuropathy different aetiological factors have to assumed. According to the prevalent factor a polyneuropathy of predominantly axonal or predominantly demyelinizing type may result.
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PMID:[Motor nerve conduction velocity in uraemic polyneuropathy: correlation with metabolic factors (author's transl)]. 101 10

Symptoms of compression of the median nerve in the carpal tunnel developed in two patients in whom an arteriovenous fistula was created to alleviate chronic renal failure through hemodialysis. Anatomic changes in the wrist area due to the fistula are probably important in the development of this syndrome, and pre-existing uremic peripheral polyneuropathy may also be important in the early development of local symptoms of nerve damage.
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PMID:Carpal tunnel syndrome: a complication of arteriovenous fistula in hemodialysis patients. 120 44

Various neurological complications may occur in patients under haemodialysis for end-stage chronic renal failure. Their frequency has clearly been reduced by improvements in the modalities and techniques of dialysis. Some of these complications are related to uremia and/or to the accumulation of endogenous toxic substances the nature of which has not been elucidated (e.g. uraemic encephalopathy, polyneuropathy), while others are directly due to the haemodialysis itself (e.g. dialysis disequilibrium syndrome, aluminum encephalopathy).
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PMID:[Neurologic complications in hemodialysis patients]. 232 90

A total of 137 patients with chronic diseases of the kidneys were examined, including 34 without and 103 with chronic renal insufficiency. The neurologic syndromes under study included encephalomyelopathy with a predominant damage to the coordination systems, polyneuropathy and myopathy. These neurological changes were expressed irrespective of chronic renal failure, while their degree directly correlated with its severity. Stabilography and tremorography proved adequate and objective methods of assessing coordination disorders and made it possible to detect the above changes at the preclinical stage.
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PMID:[Renogenic neurologic disorders]. 300 77

A variety of peripheral nerve disorders may be associated with chronic renal failure. The polyneuropathy due to uremic toxins is a distal, motor and sensory polyneuropathy in which there is segmental demyelination, axonal degeneration, and segmental remyelination. The nature of the uremic toxin and the underly mechanism of these changes is unknown. The incidence in patients with "end-stage" renal disease has fallen in recent years, severe cases now being rare, perhaps due to refinements in chronic hemodialysis, transplantation, and other therapies. However, while chronic hemodialysis stabilizes uremic neuropathy, manipulation of hemodialysis schedules may not alter its course, according to current assessment. Successful renal transplantation improves both the clinical and electrophysiological signs, even in severe uremic neuropathy.
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PMID:Peripheral neuropathies associated with chronic renal failure. 625 Jun 97


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