• 제목/요약/키워드: 다발신경병증

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Electrophysiological Features of Diabetic Polyneuropathy: Motor Nerve Conduction Studies (당뇨병성다발신경병증의 전기생리학적 특징: 운동신경전도검사)

  • Kang, Ji-Hyuk;Lee, Yun-Seob
    • The Journal of the Korea Contents Association
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    • v.10 no.10
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    • pp.237-245
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    • 2010
  • Nerve conduction studies (NCS) are the most objective measure of nerve function and essential for the diagnosis of sub-clinical neuropathy in diabetes mellitus and diabetic polyneuropathy (DPN). This study evaluates the characteristic of electrophysiological abnormalities in DPN. Electrodiagnostic data from 120 patients with diabetic polyneuropathies and 77 control subjects were reviewed. Motor nerve conduction velocities (MNCV), distal motor latencies (DML), compound muscle action potential (CMAP) amplitudes, No potential frequency and conduction block were analyzed. Data were normalized based on normative reference values, and the proportion of nerves with abnormal values in the lower and upper limbs were evaluated. DPN was systemic demyelinating peripheral polyneuropathy and more severe abnormal nerve conduction was found in lower limbs than in upper limbs. The abnormal degree was more severe in peroneal nerve. It was no statistically significant difference of conduction block in control and DPN group. Our findings suggest that DPN had more common and severe peroneal nerve involvement in the motor nerve conduction studies (MNCS). These findings have important implications for the electrophysiological evaluation of DPN.

Quantitative vibratory sense measurement systems of a diabetic neuropathy (당뇨병성 신경병증의 정량적 진동 감각 측정 시스템)

  • Ryu, Bong-Jo;Kim, Youngshik;Koo, Kyung-Wan
    • Journal of Digital Contents Society
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    • v.19 no.4
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    • pp.615-620
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    • 2018
  • Evaluation of clinical usefulness of current perception threshold test and vibration sense perception threshold test in diagnosing the diabetic poly-neuropathy patients is one of the diagnosis methods for diabetic poly-neuropathy. Up to the present, some diagnostic methods were used for diabetic poly neuropathy patients. For example, there are neuropathy impairment score test of lower limbs, nerve conduction test, cooling detection threshold test, heat-pain threshold test and so on. However, most of the above tests require very expensive cost and take a lot of time in test. In this paper, a new apparatus estimating vibration sense ability is introduced. For this purpose, the VCM(voice coil motor) stimulating patient's peripheral nerve and current amplifier were manufactured. Also, softwares sensing and driving the vibration detection threshold test in order to measure the quantitative vibration sensory levels in diabetic poly-neuropathy patients were developed.

MRI Features of Multiple Cranial Neuropathies in Guillain-Barré Syndrome Occurring after COVID-19 Vaccination: A Case Report (COVID-19 백신 접종 후 발생한 길랑-바레증후군에서 보이는 다발성 뇌신경병증의 MRI 소견: 증례 보고)

  • Youngsoo Soh;Eun Ae Yoo;Eun-Sil Kim;Soo Jung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.964-969
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    • 2023
  • Guillain-Barré syndrome (GBS) is an immune-mediated demyelinating polyneuropathy characterized by progressive, ascending, and symmetrical paralysis. It is known to be triggered by an antecedent infection or vaccination. Recently, GBS development following coronavirus disease 2019 (COVID-19) vaccination has been reported. Cranial neuropathies in typical GBS patients usually involve the facial and the lower cranial nerves (from IX to XII). We report a rare case of multiple cranial neuropathies involving trigeminal, abducens, and facial nerves in a patient who developed GBS following COVID-19 vaccination on the basis of obvious MRI features.

Sensorimotor Polyneuropathy and Multiple Cranial Neuropathies Associated with IgG κMonoclonal Gammopathy of Undetermined Significance (IgG κMonoclonal Gammopathy of Undetermined Significance와 연관된 운동신경 다발성 신경병증과 다발선 뇌신경병증)

  • Jeon, Seong-Ho;Kim, Yoon-Bong;Lee, Yeong-Bae;Park, Jong-Ho;Shin, Won-Chul;Park, Hyeon-Mi;Shin, Dong-Jin
    • Annals of Clinical Neurophysiology
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    • v.6 no.1
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    • pp.48-51
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    • 2004
  • The occurrence of polyneuropathy in association with monoclonal gammopathy of undetermined significance (MGUS) is quite common. However, reports of MGUS associated cranial neuropathies are rare. A 63 year-old women was presented with diplopia and swallowing difficulty. Neurological examination showed limitation of abduction of right eye, right peripheral facial palsy, decreased hearing and gag reflex, left side deviation of uvula, and decreased DTR. Sensorimotor polyneuropathy were observed with elctrophysiological studies. Protein and immunoelectrophoresis revealed IgG ${\kappa}$monoclonal gammopathy. She was treated with intravenous immunoglobulin and steroid, and her symptoms and signs were improved. This case suggested that she had sensorimotor polyneuropathy and multiple cranial neuropathies associated with IgG ${\kappa}$MGUS.

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Polyneuropathy and Recurrent Focal Neuropathy in Anorexia Nervosa (다발성 신경병증과 재발성 국소 신경병증을 보인 신경성 식욕부진)

  • Kim, Han-Joon;Kim, Sung Hun;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.3 no.1
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    • pp.40-42
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    • 2001
  • Anorexia nervosa(AN) is a disorder characterized by disturbance of body image, fear of gaining weight, severe weight loss and, in female, amenorrhea. Compared with normal persons, patients with AN have neuropathic symptoms more frequently. But electrophysiologic abnormalities have rarely been reported. We experienced a case with recurrent neuropathic symptoms after severe weight loss. Further evaluation revealed AN. Electrophysiologic study showed sensorimotor polyneuropathy and focal neuropathy with conduction block. As far as we know, this feature of neuropathy in AN has not been described. We describe unusual feature of neuropathy in our patient with literature review.

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy: Cons (당뇨병성 다발신경병증의 조기 진단에 있어서 신경전도검사의 유용성에 관한 논란: 부정적인 관점에서)

  • Sohn, Eun Hee
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.33-37
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    • 2008
  • Diabetic polyneuropathy (DPN) is the most common form of diabetic neuropathy, and causes a significant morbidity with an impact on the quality of life in the patients with diabetes. Since DPN frequently induces foot deformity and ulceration, which finally leads to foot amputation, the early detection and treatment is very important for the prevention of a permanent structural change. In the early stage of DPN, the diagnostic methods which can evaluate the function or structure of small nerve fibers should be employed because small nerve fibers are first involved in the course of DPN. However, the nerve conduction study cannot reflect the function of the small nerve fibers, and thus, has a definite limitation in the early diagnosis of DPN. For the early detection of DPN, electrodiagnostic data should be interpreted on a clinical context, along with the careful evaluation of the small nerve fiber functions using the tests such as the analysis of intraepidermal nerve fiber density.

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Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy (당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란)

  • Joo, In-Soo
    • Annals of Clinical Neurophysiology
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    • v.10 no.1
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    • pp.25-28
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    • 2008
  • Diabetic polyneuropathy (DPN) is the most frequently encountered form of neuropathy in diabetic patients, and it either relentlessly progresses or remains relatively stable for many years, not showing any trend towards improvement. From this point of view, early detection of DPN is very important to prevent the irreversible change of the peripheral nerve from diabetic insults. Although a number of clinical symptoms and/or deficit scales have been developed for clinical or research purposes, nerve conduction study (NCS) has been known one of the most objective and sensitive tools to detect peripheral nerve dysfunctions in diabetic patients. NCS, however, also have several shortcomings. The next two consecutive articles will focus on debates about diagnostic usefulness of NCS and on recent updates of other diagnostic tests including quantitative sensory testings and skin biopsy in the field of diabetic polyneuropathy.

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Sensorimotor Polyneuropathy Associated with Sarcoidosis (사르코이드증에 동반된 다발신경병증)

  • Ahn, Seog-Weon;Kim, Dong-Wook;Hong, Yoon-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.39-41
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    • 2003
  • Sarcoidosis is a multisystemic granulomatous disease of unknown etiology ogenesis, and most frequently presented with bilateral hilar lymphadenopathy, pulmonary infiltration, skin and eye lesion. However, neurological involvement including peripheral neuropathy is relatively rare. We report a patient who had sensorimotor polyneuropathy without other systemic symptoms or organ involvements frequently reported in sarcoidosis. Laboratory investigation suggestive of sarcoidosis lead to sural nerve biopsy for confirmation, which demonstrated noncaseating granulomatous changes. Sarcoidosis shoud be included in the differential diagnosis in subacute polyneuropathy even if there is no usual symptoms or signs suggestive of the systemic disease.

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A Case of Critical Illness Polyneuropathy and Myopathy (중환자 다발신경병증 및 근육병 1예)

  • Moon, So-Young;Lee, Sang-Soo;Lee, Sung-Hyun;Shin, Dong-Ick
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.19-22
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    • 2007
  • Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) occur commonly in the patients who have been on mechanical ventilation for more than 1 week. Even in some patients diagnosed with CIP, an underlying myopathy may be the primary cause of the muscle weakness. The cormorbid status of CIP and CIM is called as critical illness polyneuropathy and critical illness myopathy (CIPNM). We describe a 56-year-old man with acute quadriparesis and areflexia after systemic inflammatory response syndrome. The diagnosis of CIPNM is important to avoid unnecessary investigations and unreasonably pessimistic prognosis. Electrophysiologic studies are essential for the diagnosis and for planning further clinical management.

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Critical Illness Polyneuropathy (위험질병 다발신경병증)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.115-121
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    • 2001
  • The occurrence of muscle weakness in patients with sepsis or multiple organ failure managed in the intensive care unit has been recognized with increasing frequency in the last two decades. The difficulty in examining critically ill patients may explain why this complication has been only recently recognized. This weakness is due to an axonal polyneuropathy which is called critical illness polyneuropathy(CIP). It must be differentiated from myopathy or neuromuscular junction disturbance that can also occur in the intensive care setting. Neither the cause nor the exact mechanism of CIP has been elucidated. Electrophysiological studies demonstrated an acute axonal damage of the peripheral nerves. Before the recognition of CIP, these cases were usually misdiagnosed as Guillain-$Barr{\acute{e}}$ syndrome. Clinical recovery from the neuropathy is rapid and nearly complete in those patients who survive. Thus, neuropathy acquired during critical illness, although causing a delayed in weaning from ventilatory support and hospital discharge, does not worsen long-term prognosis.

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