General Concepts of Peripheral Neuropathy
Shin J. Oh in Color Atlas of Nerve Biopsy Pathology, 2001
Peripheral neuropathy is one of the most common neurological disorders and refers to a disease involving the peripheral nerves, including motor, sensory, and autonomic nerves, with predominant clinical manifestations of weakness, loss of sensation, and muscle wasting. The frequency of peripheral neuropathy is not known, but it is a common feature of many systemic diseases. Diabetes is the most common cause of peripheral neuropathy in adults living in developed countries. Considering that 1.3% of the general population of the United States has diabetes mellitus and that roughly 25% of diabetic patients have peripheral neuropathy, peripheral neuropathy is considered a common disease. In fact, 1 out of 300 individuals has peripheral neuropathy associated with diabetes. This figure excludes other causes of peripheral neuropathy.
Peripheral neuropathy
E Glucksman in MCQs in Neurology and Neurosurgery for Medical Students, 2022
This chapter provides that the themed presentation encourages quick, focused study and detailed answers aid comprehension and encourages familiarity with peripheral neuropathy with essential diagrams, colour images and sample MRIs. The ulnar nerve supplies the flexor carpi ulnaris and the ulnar half of the flexor digitorum profundus in the forearm. In the hand, it supplies the hypothenar muscles, which include the opponens digiti minimi, abductor digiti minimi and flexor digiti minimi, and also supplies the medial two lumbricals, dorsal interossei, palmar interossei and adductor pollicis. However, if the ulnar nerve lesion is more proximal (e.g. at the cubital tunnel at the elbow), the flexor digitorum profundus is denervated and hence flexion of the interphalyngeal joints does not occur and hence the ring and little fingers are held fixed in extension.
Pain Due to Nerve Injury: The Role of Nerve Growth Factor
Mark J Rowe, Yoshiaki Iwamura in Somatosensory Processing: From Single Neuron to Brain Imaging, 2001
Nerve damage due to trauma or disease often leads to chronic pain, for reasons that are poorly understood. Animal models of peripheral neuropathy have been developed in which the mechanisms underlying hyperalgesia due to nerve injury can be analysed. Nerve growth factor (NGF) is best known for its role in protecting certain classes of neurons from cell death during development. Subcutaneous injection of nerve growth factor into the hindpaws of normal rats resulted in hyperalgesia in response to both mechanical and thermal stimuli. In rats with hyperalgesia resulting from partial ligation of the sciatic nerve, significant relief of mechanical and thermal hyperalgesia was produced by intraperitoneal injection of antiserum against NGF. Degranulation was confirmed by comparing the histological profiles of mast cells in the sciatic nerves of treated and control rats. In the periphery, nerve injury would lead to elevated levels of NGF, presumably in the injured nerve or in the skin that it innervates.
Adaptation of perturbation to postural control in individuals with diabetic peripheral neuropathy
Published in International Journal of Occupational Safety and Ergonomics, 2020
Byungjoon B. J. Kim, Sunghan Kim
Loss of sensation in the feet due to diabetic peripheral neuropathy can cause deterioration of postural control and result in higher risk of trips, slips or falls. In the literature, many studies have reported that people with diabetic peripheral neuropathy tend to show greater displacement of body sway than normal people when the base of support is disrupted. But not much is known about postural characteristics of diabetics with peripheral neuropathy at the moment of postural stability disruptions and during the time span for recovering stability. The objective of this study was to analyze differences of postural characteristics between diabetics with peripheral neuropathy and diabetics without peripheral neuropathy. A learning effect of perturbation was found for the diabetic peripheral neuropathy group in the posterior direction of perturbation during the first phase, which may indicate that it could be possible to design a postural control program for those people.
Are Ergothioneine Levels in Blood Associated with Chronic Peripheral Neuropathy in Colorectal Cancer Patients Who Underwent Chemotherapy?
Published in Nutrition and Cancer, 2020
Renate M. Winkels, Lieve van Brakel, Harm van Baar, Robert B. Beelman, Fränzel J. B. van Duijnhoven, Anne Geijsen, Henk K. van Halteren, Bibi M. E. Hansson, John P. Richie, Dongxiao Sun, Evertine Wesselink, Moniek van Zutphen, Ellen Kampman, Dieuwertje E. Kok
Objective: Chronic Chemotherapy-Induced Peripheral Neuropathy (CIPN) is highly prevalent among colorectal cancer (CRC) patients. Ergothioneine (ET) – a dietary antioxidant -protected against CIPN in experimental models, but human studies are lacking. We explored whether whole blood ET levels were associated with chronic peripheral neuropathy among CRC patients who had completed chemotherapy. Methods: At diagnosis, median ET-concentration in whole blood of 159 CRC patients was 10.2 μg/ml (7.2–15.8). Patients completed questionnaires on peripheral neuropathy 6 months after completion of chemotherapy. We calculated prevalence ratios (PR) to assess associations of ET-concentrations and prevalence of peripheral neuropathy and used linear regression to assess associations with severity of peripheral neuropathy. Results: Prevalence of total and sensory peripheral neuropathy were both 81%. Higher ET-concentrations tended to be associated with lower prevalence of total and sensory peripheral neuropathy, but not statistically significant (highest versus lowest tertile of ET: PR = 0.93(0.78, 1.11) for total neuropathy, and PR = 0.84(0.70, 1.02) for sensory neuropathy). ET-concentrations were not associated with severity of neuropathy. Conclusion: Statistically significant associations were not observed, possibly because of limited sample size. Although data may putatively suggest higher levels of ET to be associated with a lower prevalence of neuropathy, analyses should be repeated in larger populations with larger variability in ET-concentrations.
Focal loss volume of ganglion cell complex in diabetic neuropathy
Published in Clinical and Experimental Optometry, 2016
Sangeetha Srinivasan, Nicola Pritchard, Geoff P Sampson, Katie Edwards, Dimitrios Vagenas, Anthony W Russell, Rayaz A Malik, Nathan Efron
BackgroundThe aim was to investigate the relationship between diabetic peripheral neuropathy (DPN) and abnormalities in ganglion cell complex (GCC); specifically, focal loss volume (FLV) and global loss volume (GLV). MethodsThe ganglion cell complex was evaluated using optical coherence tomography on 193 individuals (84 with type 1 diabetes, 67 with type 2 diabetes and 42 without diabetes). In those with diabetes, 88 had diabetes but no diabetic retinopathy (no DR group) and 63 had diabetes with diabetic retinopathy (DR group). Seventeen individuals in the no DR group and 27 in the DR group had diabetic peripheral neuropathy according to the neuropathy disability score (NDS). The probability of FLV and GLV being abnormal was determined. Forty four individuals had diabetic peripheral neuropathy (NDS of three or greater). Binary logistic regression analysis was performed, adjusting for the presence of diabetic retinopathy, age, sex, type of diabetes, duration of diabetes and HbA1c levels. ResultsTwenty‐five per cent of individuals with diabetic peripheral neuropathy had abnormal FLV compared to 11 per cent of those with diabetes but no diabetic peripheral neuropathy and five per cent in the control group (p = 0.011). Fourteen per cent of individuals with diabetic peripheral neuropathy, 10 per cent without diabetic peripheral neuropathy and two per cent in the control group had abnormal GLV (p = 0.185). For every unit increase in the neuropathy disability score, the odds of having an abnormal FLV increased by a factor of 1.25 (p = 0.007), after adjusting for potentially confounding factors. Abnormal GCC FLV is an independent predictor of diabetic neuropathy, (odds ratio = 2.94, 95 per cent CI [1.16, 7.40], p = 0.023). ConclusionDiabetic peripheral neuropathy is associated with abnormal GCC FLV at the macula, which is independent of diabetic retinopathy, age, sex, type of diabetes, duration of diabetes and HbA1c levels. An abnormality in GCC FLV is an independent predictor of diabetic peripheral neuropathy.
Related Knowledge Centers
- Diabetes Mellitus
- Nerve
- Motor Neuron
- Carpal Tunnel Syndrome
- Optic Neuritis
- Allodynia