Leprosy is chronic infectious disease caused by Mycobacterium leprae, a microorganism to which only a small portion of any given population is susceptible. Although M. leprae can be found nearly anywhere in the body outside the central nervous system, even in the more severe types of leprosy it produces significant damage only in the superficial nerves, the skin, the anterior third of eye, the upper respiratory tract, and testis. Bacillary invasion of peripheral nerve commonly occur in leprosy patients and lepromatous neuropathy is treatable neuropathy in the world. So early detection of lepromatous neuropathy is important for social adaptation and prevention of life threatening complications. For differential diagnosis with other peripheral neuropathies, general overviews of peripheral neuropathies about anatomical, clinical, laboratory and diagnostic aspects of peripheral nervous system.
Central Nervous System ; Communicable Diseases ; Diagnosis, Differential ; Humans ; Leprosy ; Mycobacterium leprae ; Peripheral Nerves ; Peripheral Nervous System ; Peripheral Nervous System Diseases ; Respiratory System ; Skin ; Testis

High-resolution ultrasound (US) of the peripheral nerves is now a standard mode of assessing neuromuscular disorders at some centers. Current standards for diagnosing peripheral neuropathies occasionally lack early sensitivity and can result in delayed diagnosis and treatment. In conjunction with electrodiagnostic studies, nerve US is particularly effective in the diagnosis of entrapment neuropathies, and may offer an alternative means of diagnosing polyneuropathies and monitoring the patient's response to therapy. This article briefly reviews the existing literature regarding ultrasonography in peripheral neuropathy and discusses its implications for diagnosis, treatment, and prognosis.
Delayed Diagnosis ; Diagnosis ; Nerve Compression Syndromes ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Prognosis ; Ultrasonography

Tingling Sensation on Hands and Feet is one of common sensory symptoms, which is frequently associated with not only peripheral nerve disorders, including polyneuropathies, entrapment neuropathies(carpal tunnel syndrome or tarsal tunnel syndrome) and radiculopathies, but also stroke or peripheral vascular diseases. Despite numerous conditions causing acroparesthesia, characteristic symptoms and signs of each category can afford to inform the critical differentiating clues like followings glove-stocking paresthesia in polyneuroapthy, dermatomal radiating paresthesia in radiculopathy, sensory level in myelopathy, and crossed paresthesia in brainstem lesion. In this review, diagnostic and therapeutic approach to acroparesthesia is schematically described. In addition, neuropathic pain, a special type of pain or unpleasant feeling caused by partial/complete denervation of sensory nervous systems, as one of common causes of acroparesthesia, will be discussed.
Brain Stem ; Denervation ; Diagnosis* ; Foot* ; Hand* ; Nervous System ; Neuralgia ; Paresthesia ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Peripheral Vascular Diseases ; Polyneuropathies ; Radiculopathy ; Sensation* ; Spinal Cord Diseases ; Stroke

The paraproteinemia is a disorder in which a single clone of plasma cells (monoclonal gammopathy) is responsible for the proliferation of monoclonal proteins (M-proteins). Approximately 10% of patients with idiopathic peripheral neuropathy have monoclonal gammopathy. Some M-proteins have the properties of an antibody to the components of peripheral nerve myelin, but the pathophysiological relationship between the neuropathy and the M-protein is often obscure. The relationship between peripheral neuropathy and monoclonal gammopathy requires the appropriate neurological and hematological investigations for precise diagnosis and treatment. In this review, we provide an update on the causal associations between peripheral neuropathy and monoclonal gammopathy as well as characteristics of clinical and electrophysiologic features.
Clone Cells ; Diagnosis ; Humans ; Myelin Sheath ; Paraproteinemias ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Plasma Cells ; Polyneuropathies

Acute neuropathic complications rarely develop in patients with inflammatory bowel disease. A case of acute peripheral neuropathy that developed only 4 weeks after a diagnosis of Crohn's disease (CD) is reported herein. Peripheral neuropathy can be a rare extraintestinal manifestation of CD. Early recognition and proper management of the neurologic complications are crucial for preventing the associated morbidity.
Crohn Disease* ; Diagnosis ; Humans ; Inflammatory Bowel Diseases ; Peripheral Nervous System Diseases* ; Polyneuropathies

BACKGROUND: Recently, the colour change plaster (NeuroCheck(R)) has been introduced, which measures sweat production on the basis of a colour change from blue to pink. This new test was useful to detect of diabetic peripheral neuropathy. The aim of this study was to evaluate the usefulness of the colour change plaster (NeuroCheck(R)) for the diagnosis of cardiac autonomic neuropathy in type 2 diabetic patients. METHODS: This study include 35 type 2 diabetic patients (10 male, 25 female) with a mean age of 55+/-14.9 years and a mean diabetes duration of 11.8+/-8.8 years. Cardiac autonomic neuropathy was diagnosed by means of Ewing's method. Peripheral autonomic neuropathy (Sudomotor function abnormality) was assessed by means of time (more than 600 seconds) until complete colour change in the indicator test. RESULTS: Peripheral autonomic neuropathy was diagnosed in 23 patients (65.7%). Time until starting colour change of plaster in normal and abnormal sudomotor patients were 38.3+/-33.7 sec and 367.1+/-470.3 sec (p<0.05). Time until completing colour change of plaster in normal and abnormal sudomotor patients were 372.5+/-198.8 sec and 1677.4+/-711.9 sec (p<0.05). The autonomic score of two groups were 2.4+/-2.3, 4.6+/-2.2 (p<0.05). Sudomotor abnormal group was older than normal (59.2+/-11.7 yrs, vs 47+/-17.4 yrs). Presence of retinopathy was related with sudomotor abnormality. Peripheral autonomic neuropathy was related with parasympathetic cardiac autonomic neuropathy. Sudomotor function abnormality was related with definite cardiac autonomic neuropathy, but it was not related with early cardiac autonomic neuropathy. The sensitivity, specificity, positive predictive value and negative predictive value of colour change plaster in the diagnosis of definitive cardiovascular autonomic neuropathy was 86.7%, 62.5%, 68.4% and 83.3%, respectively. CONCLUSIONS: The colour change plaster (NeuroCheck(R)) is not useful for the early diagnosis of cardiac autonomic neuropathy in type 2 diabetic neuropathy, but it may be possible for the screening test of definite cardiac autonomic neuropathy.
Diabetic Neuropathies ; Diagnosis* ; Early Diagnosis ; Humans ; Male ; Mass Screening ; Peripheral Nervous System Diseases ; Sensitivity and Specificity ; Sweat

Cryoglobulinemia ; physiopathology ; Humans ; Male ; Middle Aged ; Peripheral Nervous System Diseases ; diagnosis ; etiology ; Serologic Tests ; Syphilis ; diagnosis

Peripheral neuropathies are common in neurological practice, but it is also tue that they are common in many other medical and surgical fields. There are hundreds and thousands causes of peripheral neuropathies, and a variety of clinical manifestations. Diagnostic approach includes through history taking, neurologic examination focused on the motor and sensory system, serologic investigation with proper electrodiagnostic studies. The first and essential step is to know the clinical characteristics of peripheral neuropathies and caterogorize them to subtype for differential diagnosis. However, up to 30% of the neuropathy remains idiopathic despite of extensive evaluation. Symptomatic management with serial follow up is essential in these cryptogenic neuropathies. Herein, the clinical symptoms and signs of peripheral neuropathy and symptomatic management of neuropathic pain will be briefly reviewed.
Diagnosis, Differential ; Follow-Up Studies ; Neuralgia ; Neurologic Examination ; Peripheral Nervous System Diseases* ; Polyneuropathies

The detailed descriptions about clinical features and management of the different types of peripheral neuropathy are beyond the scope of this article. It may be appropriate here to outline general aspects of clinical features and classification of peripheral neuropathies. The clinical history and the abnormalities revealed by physical examination may either suggest the diagnosis or narrow down the diagnostic possibilities, facilitating subsequent investigation. Nerve conduction studies can provide crucial information and are best performed at initial examination. In general, the first broad determination should be made whether the patient has symmetrical polyneuropathy or focal, or multifocal neuropathies. The range of diagnostic possibilities differs between symmetrical polymeuropathy and mutifocal neuropathy. For those patients with symmetrical polyneuropathy, the clinical pattern (that is, whether it is motor, sensory, or mixed, or whether it has proximal or distal distribution) can provide useful information, as well as the rapidity of onset and previous clinical course in established cases. Managements of peripheral neuropathy and planning of its treatment mostly depend on the confirmative diagnosis of peripheral neuropathy. Thus, the best knowledge and understanding of basic principles of peripheral neuropathies are required for facilitating the diagnosis of peripheral neuropathies.
Classification ; Diagnosis* ; Humans ; Neural Conduction ; Peripheral Nervous System Diseases* ; Physical Examination ; Polyneuropathies

Background : diabetic neuropathy is one of the serious complication of diabetes mellitus and it can cause serious foot problems. These foot problems could be preventable if early detection method of diabetic neuropathy is established. Therefore, essential diagnostic tool is needed. The changes on electrophysiologic studies(EPS) may to be necessarily correlated with clinical neuropathy. Theater has attempted to confirm the thermography as an useful tool for detecting diabetic peripheral neuropathy. Methods : Author has studied 20 patients with diabetes visiting to department of family medicine of Korea University Hospital between December 1, 1998 and June, 30, 1999. All cases were evaluated on clinical criteria. Furthermore, the EPS and thermography have been taken. The author investigated the results of thermograpy and the relation of the clinical diagnosis and EPS. Results : among 20 cases, 12(60.0%) cases have shown abnormality on EPS and 6(30.0%) cases of them was also abnormal on clinical criteria, the other 8(40.0%) cases were normal on EPS. Results of EPS were moderately related to clinical diagnosis. 10(50.0%) cases have shown abnormality on thermography and 6(30.0%) cases of them were also abnormal on clinical criteria, the other 10(50.0%) cases were normal on thermography. Results of thermography were related to clinical diagnosis. Among 12(60.0%) cases were abnormal on EPS, 9(45%) cases also have shown abnormality on thermography. Among 8(40.0%) cases were normal on EPS, 7(35.0%) cases were also normal on thermography. Results of thermography were highly related to EPS. Conclusion : Thermography is a useful diagnostic tool in diabetic peripheral neuropathy.
Diabetes Mellitus ; Diabetic Neuropathies* ; Diagnosis ; Foot ; Humans ; Korea ; Peripheral Nervous System Diseases ; Thermography*