Respiratory Aspects of Neurological Disease
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Critical illness polyneuropathy (CIP) is a sensorimotor axonal neuropathy. CIP develops in the setting of the systemic inflammatory response syndrome (SIRS). This is a severe systemic response that occurs in up to 50 per cent of those in a critical care setting in response to infection or other insults, such as burns, trauma or surgery. There is distally predominant limb weakness, atrophy and reduced reflexes. Sensory loss can be demonstrated in patients who are able to cooperate with the examination. However, the signs are variable and difficult to elicit because of sedation or coexistent encephalopathy, an even more common complication of SIRS. Nearly half of the patients affected by CIP die of their critical illness. Of those who survive, recovery mirrors that seen in most axonal neuropathies. Those who survive with mild to moderate neuropathy recover fully over months. Those with severe neuropathy either have no recovery or a significant persistent deficit.
Otosclerosis
R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne in Scott-Brown's Essential Otorhinolaryngology, 2022
Far advanced otosclerosis is defined as average hearing thresholds of over 85 dB with unmeasurable bone conduction. This can occur in patients with conductive hearing loss from otosclerosis combined with sensory hearing loss from ageing, cochlear otosclerosis, or any other cause of sensory loss. These patients are treated either with surgery and a hearing aid or by cochlear implantation. Most clinicians offer surgery and hearing aids in the first instance with cochlear implantation reserved for those who fail the first treatment option. Cochlear implantation in patients with otosclerosis may be challenging due to the presence of otosclerotic plaques obstructing the round window or narrowing of the basal turn of the scala tympani. In addition, facial nerve stimulation from the cochlear implant is more common due to abnormal current spread in the diseased otic capsule.
Station 2: History Taking
Saira Ghafur, Parminder K Judge, Richard Kitchen, Samuel Blows, Fiona Moss in The MRCP PACES Handbook, 2017
What is Charcot–Marie–Tooth disease? A hereditary, sensory and motor neuropathy. Also known as peroneal muscular atrophy.Usually starts at puberty with foot drop and weak legs.The peroneal muscles are the first to atrophy, with upper limb signs appearing at a later stage.There is muscle wasting, pes cavus and a bilateral foot drop (high-stepping gait). Reflexes are often absent. Sensory loss is variable.The most common form is inheri ted in an autosomal dominant manner.
Epidemiological study of Spinal Cord Injury individuals from halfway houses in Shanghai, China
Published in The Journal of Spinal Cord Medicine, 2018
Feng-Shui Chang, Qi Zhang, Mei Sun, Hui-Jiong Yu, Long-Jun Hu, Jing-Hua Wu, Gang Chen, Lian-Ding Xue, Jun Lu
The symptoms of spinal cord lesions depend on the extent of the injury or non-traumatic cause, and they can include deficits in the ability to perform basic bodily functions, such as breathing, sensation, bowel and bladder control. Deficit in sensation, or sensory loss, refers to the loss of sensations such as pain, touch or temperature. Deficits in motion, or motor loss, refer to muscle weakness and the inability to use the body. We defined urination disorders as urinary retention, urinary incontinence or both, and disorders of defecation as constipation, fecal incontinence, or both. The SCI complications included bedsores, pain, urinary tract infections, and spasticity. The main medical and rehabilitation treatments received included surgery, medicine, traditional therapy (e.g., acupuncture, moxibustion, and massage), physical therapy, rehabilitation training, assistive devices (e.g., orthosis and prosthesis) and other methods appropriate for SCI individuals.
Nervous system involvement in SARS-coronavirus infection: a review on lessons learned from the previous outbreaks, ongoing pandemic and what to expect in the future
Published in International Journal of Neuroscience, 2022
Atiq ur Rehman Bhatti, Jad Zreik, Yagiz Ugur Yolcu, Mohammed Ali Alvi, Kingsley Abode-Iyamah, Alfredo Quinones-Hinojosa, Mohamad Bydon
Given the increasing evidence of neurological manifestations secondary to COVID-19, understanding the potential mechanisms of this association may aid treatment efforts. Recent reports have identified patients developing sensory loss such as smell and taste. It has been hypothesized that these symptoms are the result of inflammation in the central nervous system (CNS) such as the medulla oblongata or olfactory bulb [17–19]. However, this is largely unsupported by epidemiological evidence due to the difficulty in differentiating the pathway in the midst of a systemic infection. Another potential mechanism includes over-stimulation of the immune system in response to acute infection to the point where nerve cells are unintentionally targeted [20]. This may explain the recent reports of Guillain-Barre syndrome presenting in COVID-19 patients, but it should also be noted that the mechanism of this specific association has not yet been studied. Reports of encephalitis have also suggested direct viral injury of nervous tissue [21]. Overall, while potential mechanisms have been cautiously deduced, further studies are necessitated to better our understanding of the mechanisms by which neurological complications are manifested.
Questionnaire-based somatosensory profiling in breast cancer survivors: are we there yet? Associations between questionnaires and quantitative sensory testing
Published in Disability and Rehabilitation, 2023
Lore Dams, Elien Van der Gucht, Vincent Haenen, Nele Devoogdt, Ann Smeets, Bart Morlion, Koen Bernar, Tessa De Vrieze, Niamh Moloney, An De Groef, Mira Meeus
Based on previous studies regarding somatosensory functioning in breast cancer survivors with persistent pain in the surgical area [11–14], it was hypothesized that scores on the DN4 would be associated with both sensory loss and gain in the surgical area. However, in the current study only weak significant associations with sensory loss were found. As part of a validity study of the Dutch version of the DN4 for detection of neuropathic pain in patients with chronic pain, Timmerman et al. [38] concluded that the patients’ symptoms (DN4i) did not sufficiently correspond with clinical examination by a (pain) physician (including sensory testing of touch, pinprick, pressure, cold, heath and temporal summation) and therefore did not reliably reflect underlying pathophysiological mechanisms. These findings are in line with results of the current study [38].
Related Knowledge Centers
- Agnosia
- International Classification of Diseases
- Nerve Injury
- Optic Nerve
- Perception
- Retina
- Visual Acuity
- Visual Impairment
- Hypoxia
- Receptor
- International Classification of Diseases