Increasingly many studies have documented the clinical benefits of perineural injection therapy using 5% dextrose in water for various peripheral entrapment neuropathies. Postherpetic neuralgia is a condition involving chronic neuropathic pain caused by varicella-zoster virus, which may persist for an extended period despite continued treatment. This case series discusses three patients with postherpetic neuralgia who received ultrasound-guided subcutaneous injections with 5% dextrose, resulting in remarkable pain improvement.

Colchicine is a widely used anti-inflammatory medication, but its neuromuscular adverse effects are under-recognized. One month ago, a 70-year-old woman presented to our clinic for an evaluation of general weakness. She had been taking colchicine and diuretics daily. The weakness, which began in both thighs and lower legs approximately 4 weeks before her visit, had progressively worsened. The patient also experienced mild paresthesia and hypoesthesia in both arms and legs. Her serum creatine kinase and aldolase levels were elevated, and nerve conduction studies indicated a motor-dominant sensorimotor polyneuropathy of the axonal type. Needle electromyography showed prominent fibrillation potentials, positive sharp waves, and myotonic discharges. Suspecting colchicine-induced neuromyopathy, we discontinued the colchicine and diuretics, after which her symptoms resolved.

Glue, a volatile substance that is illegal as a recreational drug, has been popularly used for decades, and it can serve as a stepping stone for harder drugs. Chronic exposure can lead to substantial damage to several organs, including central and peripheral nervous systems. Glue-sniffing neuropathy has been reported since the 1960s, but with a lower frequency in recent years. We report a 45-year-old man who sniffed glue and presented with symmetrical distal motor weakness and paresthesia. Based on the patient’s inhalation history and initial electrodiagnostic study, we considered toxic neuropathy and demyelinating polyneuropathy in the differential diagnosis. He became chair-bound with repeating glue sniffing, and a following nerve conduction study showed the progression of motor-dominant polyneuropathies with markedly reduced amplitudes. An incomplete response to steroid therapy and recovery with inhalant cessation confirmed the diagnosis of glue-sniffing neuropathy. We conclude that glue, a neurotoxic volatile inhalant, produced glue-sniffing neuropathy with characteristic clinical and electrodiagnostic features.

Acute dystonic reactions (ADRs) are movement abnormalities characterized by involuntary muscle contractions that typically manifest after exposure to a triggering agent, such as a medication. The specific muscle groups affected determine the type of reaction. For instance, an oculogyric crisis primarily affects the ocular muscles, while oromandibular dystonia involves jaw opening and tongue protrusion. We present the rare case of a 68-year-old man with amyotrophic lateral sclerosis who was successfully treated for an ADR. The patient was admitted with loss of consciousness due to respiratory failure. Tracheostomy was promptly performed under sedation with multiple general anesthetic agents. Immediately after tracheostomy, the patient communicated via eye-blinking without any notable abnormalities, just as before the procedure. However, the following day, he became unresponsive to verbal cues and exhibited a decreased level of consciousness, accompanied by tongue dyskinesia, deviation of both eyes to the left, and loss of visual tracking. The patient’s vital signs remained stable. Brain imaging and an electroencephalogram revealed no abnormalities. Treatment with midazolam produced initial improvement; however, due to a significant side effect of hypotension, the treatment was switched to oral diazepam. The patient’s condition gradually improved, and the medication was eventually discontinued without further ADR episodes.

Lymphocele is a complication of pelvic surgery that infrequently leads to compressive neuropathy. We present a case of compressive obturator neuropathy resulting from lymphocele development after pelvic surgery. Electrodiagnostic studies revealed severe axonal disruption in the left obturator nerve, which is associated with poor functional recovery. This case underscores the role of electrodiagnostic testing in the diagnosis and rehabilitation of patients experiencing lower limb weakness following gynecological pelvic surgery.

Mutations in the adenylosuccinate synthase 1 (ADSSL1) gene, resulting in adenylosuccinate synthase deficiency, are a rare genetic anomaly characterized by muscular weakness, elevated serum creatine kinase levels, and pathological muscle findings. However, these clinical symptoms are similar to those observed in many other myopathies, increasing the risk of misdiagnosis. In an era of rapidly expanding genetic knowledge, the authors sought to verify the diagnostic utility of electromyography for genetic disorders. Through combined electrophysiological and genetic studies, a patient initially thought to have Becker’s muscular dystrophy was conclusively diagnosed with ADSSL1 mutagenic myopathy. This case underscores the importance of re-evaluating diseases that do not follow the typical clinical progression of traditional myopathies, especially in light of recent diagnostic advancements.

This case report discusses a rare instance of herpes zoster infection presenting with radiculoplexopathy, exhibiting both preganglionic and postganglionic features. A 62-year-old male patient experienced sudden right upper limb weakness following a recent herpes zoster diagnosis. A nerve conduction study, electromyography, and magnetic resonance imaging revealed a right brachial plexopathy involving the upper trunk and posterior cord, accompanied by lesions in the middle to lower cervical roots. Even after several months, the patient’s recovery remained limited, indicating the significance of this case as a reference for clinical progression in instances of both preganglionic and postganglionic neuropathy. This case emphasizes the role of electrophysiological evaluation in zoster-associated paresis to predict disease progression and improve patient management.

Facial synkinesis following severe facial palsy has been observed clinically across a wide range of patient groups, from infants to older adults, indicating that it is not limited to any specific demographic. In one of the largest studies on the natural progression of idiopathic peripheral facial nerve palsy, synkinesis was reported in approximately 16% to 55% of patients. The severity of facial synkinesis generally correlates with the severity of the initial facial palsy. Various types of nerve injuries have been categorized based on the extent of damage to the endoneurium, perineurium, and axons. Aberrant responses and ephaptic transmission following facial nerve injury are responsible for the clinical manifestations of facial synkinesis. It is crucial to minimize facial synkinesis in the early stages and to ablate it in the chronic stages to effectively manage this challenging complication following severe facial palsy. We advocate for physical therapy, including neuromuscular retraining during the acute phase, as a viable option for patients at high risk of developing facial synkinesis after a severe episode of Bell’s palsy. This approach helps prevent excessive movement (hyperkinesis) and enables patients to recognize and manage unwanted co-contractions (synkinesis). Several treatments targeting the facial nerve and muscles are available, including chemo-denervation, selective myectomy, and selective neurectomy. These interventions aim to address aberrant regeneration and peripheral ephaptic transmission.

Increasingly many studies have documented the clinical benefits of perineural injection therapy using 5% dextrose in water for various peripheral entrapment neuropathies. Postherpetic neuralgia is a condition involving chronic neuropathic pain caused by varicella-zoster virus, which may persist for an extended period despite continued treatment. This case series discusses three patients with postherpetic neuralgia who received ultrasound-guided subcutaneous injections with 5% dextrose, resulting in remarkable pain improvement.

Colchicine is a widely used anti-inflammatory medication, but its neuromuscular adverse effects are under-recognized. One month ago, a 70-year-old woman presented to our clinic for an evaluation of general weakness. She had been taking colchicine and diuretics daily. The weakness, which began in both thighs and lower legs approximately 4 weeks before her visit, had progressively worsened. The patient also experienced mild paresthesia and hypoesthesia in both arms and legs. Her serum creatine kinase and aldolase levels were elevated, and nerve conduction studies indicated a motor-dominant sensorimotor polyneuropathy of the axonal type. Needle electromyography showed prominent fibrillation potentials, positive sharp waves, and myotonic discharges. Suspecting colchicine-induced neuromyopathy, we discontinued the colchicine and diuretics, after which her symptoms resolved.