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Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Small fiber predominant peripheral neuropathy occurs when small fibers in the peripheral nervous system are damaged. In the skin, these fibers normally relay pain and temperature. In body organs, they regulate heart rate, breathing, and other automatic functions. Small fiber peripheral neuropathy can signify diabetes mellitus, or may have no underlying cause. It may be one of the earliest signs of prediabetes. Small fiber neuropathy causes pain, burning, and tingling that usually begin in the feet and progress upwards, potentially becoming severe.
Muscle Pain and Aging
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Furthermore, differences due to age also exist in the response times to 1st and 2nd pain, i.e., the elderly with respect to the young present longer reaction times to sensation onset to 1 st but not 2nd pain (22). On the whole, these findings would suggest an age-dependent change in the conduction properties of the A-delta type II nociceptive fibers, in line with the hypothesis of an age-related small-fiber peripheral neuropathy (5). According to the same author, however, the clinical impact of this change on the global capacity of pain perception in the old would be minimal, if not insignificant.
QTc ınterval is prolonged in Wilson’s disease with neurologic ınvolvement
Published in Acta Clinica Belgica, 2018
Semi Ozturk, Ahmet Seyfeddin Gurbuz, Suleyman Cagan Efe, Raim Iliaz, Mutse Banzragch, Kadir Demir
Since echocardiographic evaluation is normal in patients with WD, prolongation in QT/QTc is not associated with cardiac involvement. Rather we think it would be more related with autonomic dysfunction in patients with neurologic involvement. Several studies showed autonomic dysfunction in patients with WD. An early study asserted that mainly sympathetic functions are affected due to central neurological involvement [9]. A latter study, however, confirmed central origin of dysfunction, found equally affected sympathetic and parasympathetic functions [10]. Bhattacharya et al. demonstrated cardiac autonomic dysfunction (CAN) in patients with WD and suggested that CAN is associated with involvement of central autonomic neurons [11]. A recent study evaluated CAN in 26 WD patients in different conditions including deep breathing, Valsalva maneuver, isometric handgrip test and passive tilting and followed up the patients for 3 years [12]. This longitudinal study not only confirmed dysfunction of both sympathetic and parasympathetic systems but also association of CAN with central nervous system involvement. CAN was significant in patients with NW which is compatible with previous studies. Although central nervous system is the main location of involvement, few studies demonstrated small fiber neuropathy in WD. Von Giesen HJ et al. showed involvement of unmyelinated warm-specific C fibers independent from predominant basal ganglia motor dysfunction [13]. Gondim et al. reported small fiber neuropathy in four patients with WD and parkinsonism [14]. Latter, Sturniolo et al. showed small fiber peripheral neuropathy in corneas of WD patients [15]. Despite aforementioned studies, contribution of small nerve fiber dysfunction to CAN seems to be less significant and it must be further studied.