• 제목/요약/키워드: chronic neuropathy

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Bilateral optic neuropathy related to severe anemia in a patient with alcoholic cirrhosis: A case report and review of the literature

  • Humbertjean-Selton, Lisa;Selton, Jerome;Riou-Comte, Nolwenn;Lacour, Jean-Christophe;Mione, Gioia;Richard, Sebastien
    • 대한간학회지
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    • 제24권4호
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    • pp.417-423
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    • 2018
  • Anemia appears frequently in patients with alcoholic liver disease (ALD) but has never been linked to bilateral nonarteritic anterior ischemic optic neuropathy (NAION). A 65-year-old woman with a medical history of alcoholic cirrhosis was admitted for bilateral NAION. On admission, she was found to have a low arterial pressure and severe normocytic anemia (48 g/L). The anemia was related to chronic bleeding due to antral gastritis along with other factors associated with ALD. The applied treatment consisted of urgent transfusion followed by high doses of proton-pump inhibitors, iron and vitamin supplementation, and support in lifestyle measures. Her hemoglobin levels remained stable after 2 years but the patient still suffered from visual loss. This case highlights the link between anemia and bilateral NAION in ALD patients. The optic nerve head is prone to infarction in this context due to the vascularization characteristics of ALD. Hemoglobin levels should be monitored in ALD patients to avoid the severe complication of NAION.

Insight into the prognostic factors of chronic inflammatory demyelinating polyneuropathy

  • Baek, Seol-Hee
    • Annals of Clinical Neurophysiology
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    • 제22권1호
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    • pp.8-12
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    • 2020
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy with heterogeneous features. Appropriate treatment will produce a favorable outcome, but a poor treatment response and severe disability have also been reported. The roles of the clinical phenotypes and electrophysiological features of CIDP as well as of autoantibodies against nodal and paranodal proteins have been highlighted previously due to their association with the treatment response and long-term prognosis. This review addresses the diverse factors associated with the prognosis of CIDP.

치과 시술 후 나타난 신경손상의 관리 (Management for traumatic neuropathy after dental treatment)

  • 정성희;이선희;안용우;허준영;전혜미;옥수민
    • 구강회복응용과학지
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    • 제32권2호
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    • pp.123-129
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    • 2016
  • 의원성의 외상 혹은 감염은 신경 손상의 중요한 원인 중 하나이며, 이는 의사-환자 관계에 매우 큰 영향을 주는 일로 여겨진다. 관련 치과 술식의 예로는 임플란트 시술시 직접적인 혹은 열에 의한 손상, 근관치료시의 약제 유출, 발치시의 외력, 전달국소마취시 바늘에 의한 외상, 악골 수술로 인한 외상 등이 있다. 이러한 신경손상이 발생하지 않도록 위험군 예측 및 시술 시 주의가 필요하며, 신경 손상 시 조기 발견을 통해 제대로 대처하지 않으면 만성적 신경병증으로 발전할 수 있는 가능성이 높아질 수 있으므로 그 징후를 신속히 파악하고 적절히 관리하는 것이 매우 중요하다.

산약의 항당뇨 특성 연구(2) - NGF 유도 신경병증예방 - (Characteristics of Antidiabetic Effect of Dioscorea rhizoma(2) - Prevention of Diabetic Neuropathy by NGF Induction -)

  • 강동호;최상진;이태호;손미원;박지호;김선여
    • 한국식품영양학회지
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    • 제21권4호
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    • pp.430-435
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    • 2008
  • The main cause of diabetic neuropathy, one of the most debilitating complications, is the chronic hyperglycemia, the increase sorbitol or the decrease of nerve growth factor(NGF). NGF, a protein, plays a major role in the development and maintenance of peripheral nervous system. Systemic administration of NGF prevents manifestations of neuropathy in rodent models of diabetic neuropathy. In the previous investigation, we report the hypoglycemia effect of Dioscorea rhizoma extract(DRE) in diabetic mice. The present study shows protective effect of DRE on diabetic neuropathy by induction of NGF protein. We investigated the NGF level in salivary gland and sciatic nerve of normal mouse and the effect of DRE on sciatic nerve conductivity and thermal hyperalgesia test in Type 2 db/db mouse. DRE increased endogenous NGF level in salivary gland and sciatic nerve of mouse. And sensory nerve conductivity velocity(SNCV), motor nerve conductivity velocity(MNCV) and thermal hyperalgesia increased in DRE treatment mice compared with control group. On the basis of our results, we conclude that DRE increase induction of endogenous NGF level and have protective effect on diabetic neuropathy by induction of NGF. Therefore, we propose that long-term use of DRE might help prevention of diabetes-associated complication; diabetic neuropathy.

항암화학요법으로 유발된 만성 말초신경병증 환자의 한의학적 치험 1례 : 2년 이상 지속된 항암화학요법 유발 말초신경병증 치험 (A Case Report of Chronic Chemotherapy-Induced Peripheral Neuropathy Treated by Korean Traditional Medicine)

  • 안유민;이유나;백경민;장우석
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.892-901
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    • 2020
  • Objective: This study reports the effect of Korean traditional medicine on persistent chemotherapy-induced peripheral neuropathy (CIPN). Methods: The patient was treated with Korean traditional medicine that included acupuncture, moxibustion, and herbal medicine. The effectiveness of the treatment was evaluated by the Quality of Life Questionnaire-Core 30 (QLQ-C30), the Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (QLQ-CIPN20), the Medicinae Doctor Anderson Symptom Inventory (MDASI), and a numeral rating scale (NRS). We also used the Beck Depression Inventory (BDI) to evaluate the patient's mood change after relieving the paresthesia. Results: After treatment, the symptoms were improved. Paresthesia decreased 80%p after Korean medicine treatment. Conclusions: According to this study, Korean traditional medicine can be an effective treatment for paresthesia in patients suffering from CIPN over 2 years.

순목반사검사를 응용한 안면근육 공동반사운동 평가 (Evaluation of Facial Synkinesis With Applied Blink Reflex Test)

  • 김정미;한영수;조정선;박상은;하상원;한정호;조은경;김두응
    • Annals of Clinical Neurophysiology
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    • 제7권2호
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    • pp.88-92
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    • 2005
  • Blink reflex could be a useful tool to differentiate facial synkinesis as one of complications of facial neuropathy, from volitional associated movements. We had performed applied blink reflex test for 23 patients with objective evidence of hemifacial weakness in which orbicularis oculi muscle(zygomatic branch) and mentalis muscle(mandibular branch) are electrophysiologically evaluated in response to supraorbital stimulation of trigeminal nerve. For an unaffected side of face there is no evidence of positive blink reflex from the mentalis muscle. We concluded that a positive blink reflex from mentalis muscle is almost always suggestive of chronic facial neuropathy even in clinical silence of facial synkinesis, or an aberrant reinnervation after peripheral facial neuropathy, and does not electrophysiologically correlate with the severity of facial palsy.

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Chen 술식을 이용한 족근관절의 만성 외측 불안정에 대한 재건술 (Reconstruction for Chronic Lateral Instability of the Ankle by Chen Method)

  • 이기행;유종민;나기태;공윤배;주인탁
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.53-57
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    • 2010
  • Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

Therapeutic alternatives in painful diabetic neuropathy: a meta-analysis of randomized controlled trials

  • Vilar, Samuel;Castillo, Jose Manuel;Martinez, Pedro V. Munuera;Reina, Maria;Pabon, Manuel
    • The Korean Journal of Pain
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    • 제31권4호
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    • pp.253-260
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    • 2018
  • Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

IMS(Intramuscular Stimulation Therapy)의 이론적 배경과 임상적 운용에 대한 고찰 (An Introduction of IMS(Intramuscular Stimulation Therapy) with Theoretcial Basis and Clinical Applications)

  • 권기록;곡경승;김성욱
    • 대한약침학회지
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    • 제6권2호
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    • pp.159-164
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    • 2003
  • Results : 1. The most important concept of IMS is chronic pain illness that may develop into hypersensitivity of the nerves, i.e., neuropathy. 2. Muscle shortening may be triggered by stress, including emotional, physical, external, and internal factors. 3. Muscle shortening increases mechanical tension on the muscles as well as inducing abrasion of the tissues by stretching ligament, tendon, cartilage, bone, and etc. 4. Pain from neuropathy is normally manifested on musculoskeletal system and spasm or shortening play as the central axis of this pain. 5. Neuropathy often appears at the nerve root level and the most important decisive factor of radiculopathy is muscle shortening. 6. Spondylosis is the most common cause of radiculopathy. 7. The most significant treatment principle of IMS is to relieve muscle shortening and remove stimulating determinant from the vertebrae. 8. Dry needling is quite effective for treating various pain caused by muscle shortening.

The pathophysiology of diabetic foot: a narrative review

  • Jiyoun Kim
    • Journal of Yeungnam Medical Science
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    • 제40권4호
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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.