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Natural Products in the Treatment of Unremitting Wounds Secondary to Diabetes or Peripheral Vascular Disease
Published in Namrita Lall, Medicinal Plants for Cosmetics, Health and Diseases, 2022
Motor neuropathy involves damage to motor nerves leading to atrophy within the intrinsic muscles of the foot, loss of strength, changes in the range of motion and structural deformities of the foot and toes. More extrinsic muscle activation causes hammer-toe contractures, ankle equinus deformities and depression of the metatarsal heads (Bandyk, 2018). Significant damage can result in the complete collapse of the midfoot, called a Charcot’s foot. These changes can affect a patient’s gait pattern and place abnormal pressure on the plantar aspect of the foot and toes, leading to ulceration (Figure 6.1). A loss of thermoregulation within the autonomic system can lead to anhidrosis, or reduced sweating, and reduced sebaceous gland production. The skin’s lubrication becomes diminished, leading to dry, cracked skin and fissures, increasing the risk of ulceration and infection (Schmidt and Holmes, 2018).
The Neurologic Disorders in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Acute porphyria may include neuropsychiatric symptoms, although its true spectrum is often misunderstood and exaggerated.148 Neuropsychiatric manifestations of porphyria—significant confusion, hallucinations, and psychotic breaks—have been reported repeatedly in the literature, but there is very little to support such a connection. However, it is well known that acute porphyria can cause posterior reversible encephalopathy syndrome, which can present as acute confusion, seizures, and a decreased level of consciousness. These symptoms are all reversible after an attack has subsided. Another clear neurologic manifestation is peripheral motor neuropathy.
Classification of Neuropathy
Published in Maher Kurdi, Neuromuscular Pathology Made Easy, 2021
Peripheral neuropathy is a general medical term describing diseases affecting peripheral nerves. It may affect sensory nerves causing sensory neuropathy or motor nerves causing motor neuropathy. Coexisting motor and sensory disturbances are called sensorimotor neuropathy.
Study on autonomic neuropathy of the digestive system caused by bortezomib in the treatment of multiple myeloma
Published in Hematology, 2023
Weiwei Zhao, Juan Liu, Lianjie Wang, Wei Wang
Peripheral neuropathy induced by bortezomib is relatively common. With the in-depth study of the clinical characteristics, pathogenesis and treatment measures of sensory and motor neuropathy, the neurological symptoms can be improved to a certain extent. However, there are no effective prevention and treatment measures for autonomic neuropathy of the digestive system. According to NCI-CTC AE version 5.0 and the results of research, our centre suggests evaluating and classifying the adverse effects of the digestive system induced by bortezomib and adjusting the treatment strategy in time on the basis of the severity of autonomic neuropathy. The details are as follows: the dose or frequency of bortezomib is no need to adjust for grade 1, bortezomib is reduced to 1.0 mg/m2 or administered once a week for grade 2, treatment is suspended until the symptoms are significantly alleviated by one level for grade 3, and treatment is terminated for grade 4. In this study, 26 patients with intestinal obstruction were cured after reducing the dose or frequency of bortezomib as shown in Table 3 and conservative treatment, two patients were ineffective and died after giving up further treatment. Autonomic neuropathy of the digestive system was characterized by rapid progress, severe disease and easy to be ignored. It should be closely monitored, diagnosed and treated early to improve the prognosis of patients.
Polyneuropathy Associated with Age of Starting the Transfusion and Serum Ferritin Level in Iranian Patients with Thalassemia Major and Intermedia
Published in Hemoglobin, 2023
Aziz Eghbali, Kazem Ghaffari, Roya shaykh Baygloo, Aygin Eghbali, Ali Ghasemi
We present results that support the existence of polyneuropathy in patients with thalassemia major. This study is the first reevaluation of neuropathy in the era of new iron chelators including DFX in Iran. In the current study, 13% of our patients had signs and/or symptoms that could be attributed to neuropathy and NCS data showed that 31.8% of patients had evidence of neuropathy. Although we found both sensory and motor nerve abnormality in this study, Sawaya et al. [15] reported only sensory nerve abnormality in thalassemia patients. In previous studies, the prevalence of neuropathy was reported between 22–78% [2]. Stambolis et al. showed abnormalities in NCS results in about 52% of patients, while only 25% of patients were symptomatic [18]. Khosravi and colleagues reported the peripheral neuropathy in β-thalassemia major in 65 patients who received regular blood transfusion and DFO chelating therapy, at least for ten years. The percentage of patients with peripheral neuropathy was 66.15%. The authors found that there was significant association between aging and peripheral neuropathy, but there was no significant association with gender, serum ferritin level and splenectomy [19]. Also, El-Tagui et al. reported that 63.3% of patients had motor neuropathy in the absence of sensory neuropathy or myopathy [17], whereas in this study, two patients (4.5%) had sensory neuropathy.
Plasma neurofilament light chain: an early biomarker for hereditary ATTR amyloid polyneuropathy
Published in Amyloid, 2020
Luis F. Maia, Aleksandra Maceski, Isabel Conceição, Laura Obici, Rui Magalhães, Andreas Cortese, David Leppert, Giampaolo Merlini, Jens Kuhle, Maria João Saraiva
Transthyretin amyloidosis due to V30M mutation (ATTR-V30M), also known as familial amyloid polyneuropathy (FAP), is the most frequent hereditary transthyretin amyloidosis. The most frequent clinical phenotype at disease onset is a combination of sensory and dysautonomic symptoms due to an axonal small fibre polyneuropathy [1,2]. Later in the course of the disease motor neuropathy and progressive disability emerge. ATTR-V30M amyloidosis is an highly disabling disease that leads to death within 7–12 years after onset if left untreated [3]. Currently, patients are stratified according to clinical scales that are subjective and entail a high degree of inter-rater and inter-test variability [4–6]. So, disease biomarkers are needed to allow better patient stratification and treatment monitoring.