China
Africa
Explore chapters and articles related to this topic
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Mononeuropathy multiplex is dysfunction of multiple individual peripheral nerves. If many nerves are involved, the neuropathies may coalesce into a pattern that resembles a polyneuropathy. In order to distinguish between these two entities, a thorough history of present illness is essential.
Stroke mimics
Published in Christos Tziotzios, Jesse Dawson, Matthew Walters, Kennedy R Lees, Stroke in Practice, 2017
Christos Tziotzios, Jesse Dawson, Matthew Walters, Kennedy R Lees
Any of the peripheral neuropathies, whether mononeuropathy, polyneuropathy, or mononeuropathy multiplex, may present acutely. Their causes vary from infectious and neoplastic to autoimmune and toxic and metabolic. Distinguishing peripheral from central lesions (stroke) should not present a diagnostic challenge and goes back to the basics of clinical history, neurological examination, and the presence or lack of relevant risk factors.
The neurologic approach
Published in Stanley Berent, James W. Albers, Neurobehavioral Toxicology, 2012
Stanley Berent, James W. Albers
The peripheral nervous system is, in general, a sensitive indicator of nervous system involvement from neurotoxic chemicals (Albers & Bromberg, 1995). Numerous neurotoxicants produce recognizable peripheral nervous system effects as part of their overall involvement when given in sufficient dose and over a sufficient period. The concept that the peripheral nervous system is sometimes involved as part of more generalized nervous system or systemic toxicity is important because the most objective and quantifiable evaluation techniques available to the neurologist measure peripheral nervous system performance. The characteristic peripheral nervous system abnormality following neurotoxic exposure is peripheral neuropathy. ‘Neuropathy’ is a general term that literally means ‘sick nerve’. The term is used to denote damage to the peripheral nervous system. ‘Mononeuropathy’ indicates involvement of a single peripheral nerve. ‘Mononeuropathy multiplex’ indicates involvement of multiple individual nerves. ‘Polyneuropathy’ indicates diffuse or generalized involvement of most or all nerves. The terms ‘neuropathy’, ‘peripheral neuropathy’, and ‘polyneuropathy’ are used interchangeably in reference to generalized involvement of the peripheral nervous system. There are several different types of peripheral neuropathy, including those classified as sensory, motor, sensorimotor, and/or autonomic, depending on the predominant class of nerve fiber involved.
Cutaneous polyarteritis nodosa with necrotising vasculitis in the fascia
Published in Modern Rheumatology Case Reports, 2018
Yushiro Endo, Keita Fujikawa, Akinari Mizokami, Kunihiko Nagasato, Masahiro Nakashima, Tomohiro Koga, Atsushi Kawakami
Needle electromyography was performed in the left vastus lateralis muscle, left tibialis anterior muscle and left gastrocnemius muscle, and the former two muscles showed short persistent and multiphasic motor unit action potential, which suggested myositis. The nerve conduction velocity was performed in the left ulnar nerve, left sural nerve and left tibial nerve, and all showed low amplitudes, which indicated mononeuropathy multiplex. Magnetic resonance imaging revealed markedly increased signal intensity of muscles and fascia and subcutaneous tissue in the lower limbs (Figure 2). We performed an en bloc muscle biopsy of the left vastus lateralis muscle, including resection of the skin, subcutaneous tissue, fascia and muscle. The biopsy specimen showed fibrinoid necrotising arteritis with neutrophilic and eosinophilic infiltrates in the fascia along with mild inflammatory cell infiltration of muscle and subcutaneous tissue (Figure 3). Neither the whole-body contrast computed tomography angiography nor the head magnetic resonance angiography showed findings of aneurysm, irregularity, stenosis, or obstruction in the arterial wall.
Diagnosis and management of Lyme neuroborreliosis
Published in Expert Review of Anti-infective Therapy, 2018
Finally, nearly all experimentally infected rhesus macaque monkeys [21] develop a virtually identical patchy inflammatory peripheral nerve disorder – again without consistent CSF abnormalities. It appears in all circumstances a multifocal inflammatory process leads to peripheral nerve damage. The mechanism remains elusive – neither spirochetes, spirochete antigens, antibodies, immune complexes, nor complement are demonstrable in biopsies [21]. However, the observations that nerve damage can occur prior to the presence of demonstrable serum or CSF antibody, that immune mediators are not evident in involved nerves, and that symptoms respond rapidly to antibiotics all argue for an important role of active infection, and against a purely immune-mediated mechanism [22], such as occurs in a small subset of patients with Lyme arthritis [23]. It follows that the clinical spectrum of neuroborreliosis should include the full range of presentations of mononeuropathy multiplex – but not demyelinating or ‘dying back’ neuropathies.
Polyneuropathy and the sural/radial sensory nerve action potential ratio in primary Sjögren’s syndrome
Published in Neurological Research, 2020
Yasemin Eren, Nese Gungor Yavasoglu, Cem Ozisler
The peripheral and central nervous system are affected in pSS. Its prevalence varies between 8–49%. Many studies have reported that the true prevalence of neurologic manifestations in Sjögren’s syndrome is 20% [2]. Predominantly sensory axonal neuropathy and sensorimotor axonal polyneuropathy are the most common manifestations of peripheral nerve disease [4–6]. Mononeuropathy multiplex, polyradiculopathy, trigeminal neuropathy, multiple cranial neuropathies, autonomic neuropathy, myopathy and central nervous system involvement are also observed [7,8].