• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.153-158
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• 2018

Posterior interosseus (PI) nerve compression is a rare form of compressive neuropathy. It can cause pain along the radial nerve course and weakness of radial nerve innervating muscles without sensory symptoms. A 65-year-old man visited our institution complaining weakness of finger extension and thumb abduction after 2 times of injections at the right elbow in local clinic. The patient's clinical history and physical examination implied an iatrogenic radial nerve injury caused by the injection. The electrophysiologic study revealed of posterior interosseus neuropathy (PIN) with incomplete conduction block. However, the ultrasound study showed that the PI nerve was compressed by an anechoic cyst. The magnetic resonance imaging also confirmed of a ganglion cyst, not a hematoma. After repeated aspirations and a steroid injection, the electrophysiologic study showed recovery of motor weakness. Despite of the clue which implying an iatrogenic injury, clinician should consider other possibilities such as ganglion cysts and ultrasound guided aspiration and steroid injection could be an effective option for conservative management.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.328-334
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• 2023

An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.63-70
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• 2006

Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.

• Annals of Clinical Neurophysiology
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• v.19 no.2
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• pp.148-150
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• 2017

Peripheral neuropathy associated with hyper-IgE-emia have been rarely reported. Here we present a 72-year-old man with acute motor axonal neuropathy who had relatively poor prognosis. The serum was weakly positive for IgG GQ1b and GT1a, and serum IgE was significantly elevated. He was transferred to a rehabilitation center with Medical Research Council grade 3 lower extremity weakness on admission day 65. We would suggest that hyper-IgE-emia may increase the magnitude and rate of neural damage in this case.

• Annals of Clinical Neurophysiology
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• v.8 no.1
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• pp.48-52
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• 2006

Background: Intravenous immunoglobulin (IVIg) has been administered for various immune-mediated neurological diseases such as autoimmune neuropathy, inflammatory myopathies, and other autoimmune neuromuscular disorders. The purpose of this study is to investigate side effects and complications of IVIg therapy in neuromuscular disorders. Methods: We enrolled 29 patients (age 8~63 years) with IVIg therapy for various neurological diseases including Guillain-Barre syndrome, myasthenia gravis, dermatomyositis, polymyositis, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. IVIg therapy was used at a dose of 0.4 g/kg body weight/day for 5 consecutive days. Results: 10 patients (34%) had adverse events. There are adverse events in 16 courses (11%) among total 145 courses. The majority of patients presented with mild side effects, mostly asymptomatic laboratory changes. Rash or mild headache occurred in 3 patients. One patient showed a serious side effect of deep vein thrombosis. Conclusions: IVIg therapy is safe for a variety of immune-mediated neurological diseases in our study.

• Biomolecules & Therapeutics
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• v.27 no.1
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• pp.85-91
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• 2019

Oxidative stress is considered a major contributor in the pathogenesis of diabetic neuropathy and in diabetes complications, such as nephropathy and cardiovascular diseases. Diabetic neuropathy, which is the most frequent complications of diabetes, affect sensory, motor, and autonomic nerves. This study aimed to investigate whether 7,8-dihydroxyflavone (7,8-DHF) protects SH-SY5Y neuronal cells against high glucose-induced toxicity. In the current study, we found that diabetic patients exhibited higher lipid peroxidation caused by oxidative stress than healthy subjects. 7,8-DHF exhibits superoxide anion and hydroxyl radical scavenging activities. High glucose-induced toxicity severely damaged SH-SY5Y neuronal cells, causing mitochondrial depolarization; however, 7,8-DHF recovered mitochondrial polarization. Furthermore, 7,8-DHF effectively modulated the expression of pro-apoptotic protein (Bax) and anti-apoptotic protein (Bcl-2) under high glucose, thus inhibiting the activation of caspase signaling pathways. These results indicate that 7,8-DHF has antioxidant effects and protects cells from apoptotic cell death induced by high glucose. Thus, 7,8-DHF may be developed into a promising candidate for the treatment of diabetic neuropathy.

• Annals of Clinical Neurophysiology
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• v.8 no.1
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• pp.102-105
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• 2006

We present a case with stepwise weakness and sensory involvement of both hands for more than 2 months. His nerve conduction study findings revealed prolonged terminal latencies, decreased motor and sensory conduction velocities and conduction blocks of both ulnar nerves, more severely on left side. And there were other abnormalities manifested with mononeuropathy multiplex. Increased cerebrospinal fluid protein was found. We diagnosed him as Lewis-Sumner syndrome and tried high dose oral steroid therapy for 2 months. He showed improvement of motor functioning with persistent conduction block.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.267-270
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• 2018

Recurrent motor branch entrapment syndrome is a compressive mononeuropathy of recurrent motor branch of median nerve. It is a rare condition as a cause of thenar muscle wasting and may have different pathogenesis. If such an anatomical variation is the cause, there is a possibility that thenar muscle atrophy remains if only the transcarpal ligament release is performed. We report a 25-year-old male patient with carpal tunnel syndrome with thenar muscle wasting 1 month ago.

• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.282-292
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• 1993

Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by cliniical neurologists and neurotoxicologists to evaluate neurotoxicity in working populations is a necessity fur the occupational physician. To investigate the effects of carbon disulfide($CS_2$) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of $CS_2$-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between $CS_2$-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.

• Annals of Clinical Neurophysiology
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• v.25 no.2
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• pp.84-92
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• 2023

Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.