No abstract available.
Diagnosis ; Myotonia ; Polyneuropathies ; Relaxation

Delayed peripheral polyneuropathy caused by organophosphorus intoxication is not uncommon. This is a case report of 32 years old female with peripheral polyneuropathy which is appeared two weeks after organophosphorus poisoning. It is characterized by calves pain followed by minmal sensory change and predominant motor weakness affecting the distal part of the limbs. The electrophysiologic and pathologic studies support the clinical diagnosis. The exact pathogenesis is still debated, but phosphorylation of neurotoxic esterase (NTE), followed by "aging" process was suspected to play a role in the development of axonal degeneration.
Adult ; Axons ; Diagnosis ; Extremities ; Female ; Humans ; Organophosphate Poisoning ; Phosphorylation ; Polyneuropathies*

BACKGROUND: Nerve conduction study is an objective and quantitative diagnostic method for the diagnosis and follow-up study of polyneuropathy. Sometimes it is hard to interpret the nerve conduction study, because there are many segmental variables to test and uneven distribution of abnormalities in polyneuropathy. And there can be some interpersonal differences in the interpreting the results. It is obvious that one objective and quantitative value that represents the many segmental variables is helpful for the clinical interpretation and follow?up of polyneuropathy. METHODS: We evaluated 242 normal subjects and 71 patients with demyelinating polyneuropathy to find out a standardized representative value, distinguishing patients from normal subjects. The standardized representative value was made by combination of the some standardized segmental variables which showed marked differences between two groups. We evaluated the clinical usefulness of this value by comparing the sequential changes of this value with the clinical course. RESULTS: Statistically significant differences were present in each segmental value of the nerve conduction study between the groups of patients and normal persons. The diagnostic sensitivity of the segmental value was in range of 25.7%-81.8% in case of 2SD criteria. The diagnostic sensitivity of each functional standardized value - average of the segmental standardized values of same nature - was in range of 54.1%-89.9% in case of 2SD criteria. Using 3SD criteria the sensitivity was reduced to 20.9%-81.1%, more in sensory and mixed nerve than motor nerve. By combination of these functional standardized values, the diagnostic sensitivity could increase up to 79.1%-93.2% on 3SD criteria. CONCLUSION: The best combination which represents the NCV study is the average of the motor nerve terminal latency, the motor nerve conduction velocity, and the ratio of conduction block with 93.2% sensitivity and 100% specificity. This representative value well reflects the clinical course of patient in follow-up studies.
Diagnosis* ; Follow-Up Studies* ; Humans ; Neural Conduction* ; Polyneuropathies* ; Sensitivity and Specificity

Biopsy ; methods ; Electromyography ; Humans ; Muscles ; pathology ; Polyneuropathies ; diagnosis

Peripheral polyneuropathy is caused by various disorders such as diabetes mellitus. Cryoglobulinemia, as a cause of peripheral polyneuropathy, has been well documented in many reports. Recently we experienced a case of essential cyroglobulinemic polyneuropathy and therapeutic effect of plasmapheresis was shown even in chronic periods. In a patient with peripheral polyneuropathy with no known etiology, one should always consider cryoglobulinemia as a cause since early diagnosis and proper treatment will lead to better outcome.
Cryoglobulinemia ; Diabetes Mellitus ; Early Diagnosis ; Humans ; Plasmapheresis ; Polyneuropathies

Acute sensorimotor polyneuropathy that resembles Guillain-Barre syndrome (GBS) is rarely accompanied with nephrotic syndrome, and its underlying immunological mechanisms are unclear. A 56-year-old man presented with simultaneous acute progressive symmetric sensorimotor polyneuropathy and proteinuria. A kidney biopsy revealed focal segmental glomerulosclerosis. Serial electrophysiologic studies showed only a transient proximal conduction block in the median nerve, stimulated somatosensory evoked potential and prolonged terminal latencies of the median and peroneal nerves. The patient's neurologic deficits and kidney dysfunction recovered with corticosteroid treatment. Our case showed that somatosensory evoked potential study can be an important objective tool in the diagnosis of acute polyneuropathy with normal distal nerve conduction and that corticosteroids should be considered in the initial treatment of GBS-resembling polyneuropathy associated with nephrotic syndrome.
Evoked Potentials, Somatosensory/physiology ; Humans ; Male ; Middle Aged ; Nephrotic Syndrome/*diagnosis/*physiopathology ; Polyneuropathies/*diagnosis/*physiopathology

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

Child, Preschool ; Critical Illness ; Female ; Humans ; Male ; Muscular Diseases ; diagnosis ; Polyneuropathies ; diagnosis

The possibility of whether minimal F-wave latency and a simple ratio between the sural and superficial radial sensory response amplitudes may provide a useful electrodiagnostic test in diabetic patients was investigated in this report. To evaluate the diagnostic sensitivity of minimal F-wave latency, the Z-scores of the minimal F-wave latency, motor nerve conduction velocity (MCV), amplitude of compound muscle action potentials (CMAP), and distal latency (DL) of the median, ulnar, tibial, and peroneal nerve were compared in 37 diabetic patients. For the median, ulnar, and tibial nerves, the Z scores of the minimal F-wave latency were significantly larger than those of the MCV. In addition for all four motor nerves, the Z scores of the minimal F-wave latency were significantly larger than those for the CMAP amplitude. Furthermore, 19 subjects showing abnormal results in the standard sensory nerve conduction study had a significantly lower sural/radial amplitude ratio (SRAR), and 84% of them had an SRAR of less than 0.5. In conclusion, minimal F-wave latency and the ratio between the amplitudes of the sural and superficial radial sensory nerve action potential are sensitive measures for the detection of nerve pathology and should be considered in electrophysiologic studies of diabetic polyneuropathy.
Aged ; Diabetic Neuropathies/physiopathology ; Diabetic Neuropathies/diagnosis* ; Electrodiagnosis* ; Female ; Human ; Male ; Middle Age ; Polyneuropathies/physiopathology ; Polyneuropathies/diagnosis* ; Radial Nerve/physiopathology* ; Reaction Time ; Sural Nerve/physiopathology*

Cerebrotendinous xanthomatosis is a rare autosomal recessive disease that involves multiple organs, including the peripheral nervous system. The present study is the first to report the ultrasonographic findings of peripheral nerves in a patient with cerebrotendinous xanthomatosis. The patient presented with bilateral Achilles tendon enlargement and foot hypesthesia. Sonographic examination revealed hypoechoic, swollen peripheral nerves with enlarged bilateral Achilles tendons. Since the ultrasonographic findings revealed peripheral involvement, the diagnosis of cerebrotendinous xanthomatosis was established after laboratory and genetic studies along with clinical findings.
Achilles Tendon ; Diagnosis ; Foot ; Humans ; Hypesthesia ; Peripheral Nerves ; Peripheral Nervous System ; Polyneuropathies* ; Ultrasonography* ; Xanthomatosis, Cerebrotendinous*