Articles Tagged With: Neuropathy
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Long-Term Peripheral Nerve Function Changes in People with Well-Controlled Type 2 Diabetes
The authors conducted a prospective observational study comparing the effect of early diagnosed, well-controlled type 2 diabetes on peripheral nerve function. Overall, they found similar rates of decline in nerve function in people with well-controlled diabetes compared to age- and sex-matched individuals with normal glucose tolerance. Given the similar decline in nerve function, the authors concluded that the course of diabetic sensorimotor neuropathy is influenced primarily by nerve function at the time of diagnosis and age-related physiological decline.
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Clinical Features of Biopsy-Proven Large-Arteriole and Microvasculitis in Peripheral Nerves
In this retrospective, an observational cohort study undertaken to characterize the clinical features of nerve vasculitis based on vessel size, large-arterial vasculitis (≥ 75 microns) in comparison to microvasculitis (< 75 microns) was demonstrated. Large arteriole vasculitis usually was a distal symmetrical polyneuropathy and associated with a systemic vasculitis illness. Microvasculitis most often presented with radiculopathy and/or plexopathy and was not associated with systemic illness.
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Clinical Insights on Managing DPN and PAD in Patients with Diabetes
Given the significant prevalence of diabetes in the population, it is important for the primary care clinician to be familiar with the many types of neuropathies commonly affecting people living with diabetes. By far the most prevalent type is chronic diabetic peripheral sensorimotor neuropathy, affecting up to 50% of people with diabetes. Peripheral arterial disease (PAD) refers to partial or complete occlusion of peripheral vessels of the lower extremities. The underdiagnosis of PAD in the primary care setting may be a major issue because of many patients presenting without the typical claudication symptoms described in medical textbooks. The ability of primary care clinicians to diagnose PAD in asymptomatic patients still has a significant clinical effect because PAD acts as a marker for systemic atherosclerosis.
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Small Fiber Neuropathy in Post-COVID Patients with Chronic Fatigue Syndrome
This study examines small fiber neuropathy (SFN) in post-COVID patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). While ME/CFS patients reported more SFN symptoms, objective testing showed limited diagnostic value beyond heat/cold detection differences.
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Monotruncular (Monomelic) CIDP
In this study, the authors describe the clinical, electrophysiological, and radiological features of patients with multifocal chronic inflammatory demyelinating polyneuropathy (CIDP) that presented with monotruncular (monomelic) onset.
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Hepatitis E and Neuropathy
In this prospective case-control study of patents with neuralgic amyotrophy, Guillain-Barré syndrome, and Bell’s palsy, an association with acute hepatitis E infection was demonstrated only with neuralgic amyotrophy.
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Nitrous Oxide-Induced Neuropathy
Nitrous oxide-induced neuropathy presents with a rapidly progressive sensorimotor neuropathy that may mimic Guillain-Barré syndrome. The pattern of clinical weakness and progression, as well as electrophysiological features, can help to rapidly distinguish the two disorders.
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Involvement of the Peripheral Nervous System in Neurolymphomatosis
Lymphoma that presents with peripheral neuropathy is a challenging diagnosis. Diagnosis and treatment often are delayed, but they can be facilitated by early consideration and imaging with fluorodeoxyglucose-positron emission tomography. Early diagnosis and hematologic treatment may be effective.
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The Neural Pathways of Pain Treatment Response in Small-Fiber Neuropathy
Pain in peripheral neuropathy, referred to as neuropathic pain, is thought to result from overexpression of pain receptors, regeneration of hypersensitive nerve sprouts, and denervation hypersensitivity of neurons in the sensory ganglia. Additionally, activation of the pain pathways appears to induce secondary structural and functional changes in the brain that contribute to pain perception, persistence, and response.
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The Effect of Peripheral Neuropathy in Parkinson’s Disease on Gait and Balance
In this cohort study of 99 patients with Parkinson’s disease (PD), 40% were found to have peripheral neuropathy, with the majority meeting criteria for small fiber neuropathy. Gait and balance were worse in PD patients with neuropathy compared to those without.