Pub Date : 2019-07-24DOI: 10.5772/intechopen.81966
G. Özdemir
The aim of this chapter was to define an unexplained nonclassified polyneuropathy condition as a new neurological disease. This new diagnosis of occupation-related polyneuropathy has been named as “working hand syndrome (WHS).” This study collected and compared clinical and electrophysiological analyses data from healthy controls, WHS patients, carpal tunnel syndrome (CTS) patients, and polyneuropathy patients. The WHS patients presented to the clinic with pain, numbness, tingling, and burning sensations in their hands that increased significantly during rest and nighttime. However, there was no weakness in the muscles, and the deep tendon reflexes were normal in this disease. The patients had all been working in physically demanding jobs requiring the use of their hands/arms for at least 1 year, but no vibrating tools were used by the patients. All of the cases were men. I suppose that overload caused by an action repeated chronically by the hand/arm may impair the sensory nerves in mentioned hand/arm. In patients with these complaints, for a definitive diagnosis, similar diseases must be excluded. Nonetheless, the specific electrophysiological finding that the sural nerves are normal on the lower sides, as well as the occurrence of sensory axonal polyneuropathy in the sensory nerves without a significant effect on velocity and latency in the work-ups of the upper extremity are enough to make a diagnosis.
{"title":"Working Hand Syndrome: A New Definition of Nonclassified Polyneuropathy Condition","authors":"G. Özdemir","doi":"10.5772/intechopen.81966","DOIUrl":"https://doi.org/10.5772/intechopen.81966","url":null,"abstract":"The aim of this chapter was to define an unexplained nonclassified polyneuropathy condition as a new neurological disease. This new diagnosis of occupation-related polyneuropathy has been named as “working hand syndrome (WHS).” This study collected and compared clinical and electrophysiological analyses data from healthy controls, WHS patients, carpal tunnel syndrome (CTS) patients, and polyneuropathy patients. The WHS patients presented to the clinic with pain, numbness, tingling, and burning sensations in their hands that increased significantly during rest and nighttime. However, there was no weakness in the muscles, and the deep tendon reflexes were normal in this disease. The patients had all been working in physically demanding jobs requiring the use of their hands/arms for at least 1 year, but no vibrating tools were used by the patients. All of the cases were men. I suppose that overload caused by an action repeated chronically by the hand/arm may impair the sensory nerves in mentioned hand/arm. In patients with these complaints, for a definitive diagnosis, similar diseases must be excluded. Nonetheless, the specific electrophysiological finding that the sural nerves are normal on the lower sides, as well as the occurrence of sensory axonal polyneuropathy in the sensory nerves without a significant effect on velocity and latency in the work-ups of the upper extremity are enough to make a diagnosis.","PeriodicalId":101960,"journal":{"name":"Demystifying Polyneuropathy - Recent Advances and New Directions","volume":"20 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130960596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-07DOI: 10.5772/INTECHOPEN.82271
M. Snoussi, F. Frikha, Z. Bahloul
Connective tissue diseases are characterized by different organ disorders due to loss of immune system tolerance to autoantigens. Peripheral neuropathy is one of the features of these diseases with variable frequency; it is more prevalent in Sjögren syndrome. Peripheral neuropathy is often seen in the course of the disease. Nonetheless, it may be also a presenting sign or the unique feature of immune system dysfunction. Neuropathies in connective tissue diseases are related mainly to vasculitic disorder. It requires prompt diagnosis and treatment to improve its outcome. Peripheral neuropathy in connective tissue diseases could be multifocal and asymmetric, or confluent and symmetrical. This chapter reviews the clinical, diagnostic and therapeutic features of neuropathies associated with the common diffuse connective tissue diseases.
{"title":"Peripheral Neuropathy in Connective Tissue Diseases","authors":"M. Snoussi, F. Frikha, Z. Bahloul","doi":"10.5772/INTECHOPEN.82271","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82271","url":null,"abstract":"Connective tissue diseases are characterized by different organ disorders due to loss of immune system tolerance to autoantigens. Peripheral neuropathy is one of the features of these diseases with variable frequency; it is more prevalent in Sjögren syndrome. Peripheral neuropathy is often seen in the course of the disease. Nonetheless, it may be also a presenting sign or the unique feature of immune system dysfunction. Neuropathies in connective tissue diseases are related mainly to vasculitic disorder. It requires prompt diagnosis and treatment to improve its outcome. Peripheral neuropathy in connective tissue diseases could be multifocal and asymmetric, or confluent and symmetrical. This chapter reviews the clinical, diagnostic and therapeutic features of neuropathies associated with the common diffuse connective tissue diseases.","PeriodicalId":101960,"journal":{"name":"Demystifying Polyneuropathy - Recent Advances and New Directions","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114547658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.81687
O. García-Suárez, Y. García-Mesa, J. García-Piqueras, G. Salvo, Juan L. Cobo, E. Alba, R. Cobo, J. Feito, José A. Vega
Cutaneous biopsy is a complementary method, alternative to peripheral nerve biopsy, for the analysis of nerve involvement in peripheral neuropathies, systemic diseases, and several pathologies of the central nervous system. Most of these neuropathological studies were focused on the intraepithelial nerve fibers (thin-myelinated A δ fibers and unmyelinated C fibers), and few studies investigated the variations in dermal innervation, that is, large myelinated fibers, Merkel ’ s cell-neurite complexes, and Meissner ’ s corpuscles. Here, we updated and summarized the current data about the quantitative and qualitative changes that undergo MCs and MkCs in peripheral neuropathies. Moreover, we provide a comprehensive rationale to include MCs in the study of cutaneous biopsies when analyzing the peripheral neuropathies and aim to provide a protocol to study them.
{"title":"The Cutaneous Biopsy for the Diagnosis of Peripheral Neuropathies: Meissner’s Corpuscles and Merkel’s Cells","authors":"O. García-Suárez, Y. García-Mesa, J. García-Piqueras, G. Salvo, Juan L. Cobo, E. Alba, R. Cobo, J. Feito, José A. Vega","doi":"10.5772/INTECHOPEN.81687","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81687","url":null,"abstract":"Cutaneous biopsy is a complementary method, alternative to peripheral nerve biopsy, for the analysis of nerve involvement in peripheral neuropathies, systemic diseases, and several pathologies of the central nervous system. Most of these neuropathological studies were focused on the intraepithelial nerve fibers (thin-myelinated A δ fibers and unmyelinated C fibers), and few studies investigated the variations in dermal innervation, that is, large myelinated fibers, Merkel ’ s cell-neurite complexes, and Meissner ’ s corpuscles. Here, we updated and summarized the current data about the quantitative and qualitative changes that undergo MCs and MkCs in peripheral neuropathies. Moreover, we provide a comprehensive rationale to include MCs in the study of cutaneous biopsies when analyzing the peripheral neuropathies and aim to provide a protocol to study them.","PeriodicalId":101960,"journal":{"name":"Demystifying Polyneuropathy - Recent Advances and New Directions","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133952952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.81176
F. Octaviana, A. Safri, D. Imran, P. Price
As advances in the treatment of HIV are now allowing patients a longer life span, further comorbidities become apparent. This includes sensory neuropathy (HIV-SN) which can affect a patient’s quality of life. Here, we review factors influencing HIV-SN in patients receiving antiretroviral therapy that promotes this condition and in the modern era when these therapies have been withdrawn. This has halved the incidence of HIV-SN, but the condition remains significant in the lives of many sufferers. Genetic polymorphisms that influence pathogenesis of HIV-SN have indicated likely mechanisms, but studies of skin biopsies and animal models are needed to confirm the roles of the encoded proteins.
{"title":"HIV-Associated Sensory Neuropathy","authors":"F. Octaviana, A. Safri, D. Imran, P. Price","doi":"10.5772/INTECHOPEN.81176","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81176","url":null,"abstract":"As advances in the treatment of HIV are now allowing patients a longer life span, further comorbidities become apparent. This includes sensory neuropathy (HIV-SN) which can affect a patient’s quality of life. Here, we review factors influencing HIV-SN in patients receiving antiretroviral therapy that promotes this condition and in the modern era when these therapies have been withdrawn. This has halved the incidence of HIV-SN, but the condition remains significant in the lives of many sufferers. Genetic polymorphisms that influence pathogenesis of HIV-SN have indicated likely mechanisms, but studies of skin biopsies and animal models are needed to confirm the roles of the encoded proteins.","PeriodicalId":101960,"journal":{"name":"Demystifying Polyneuropathy - Recent Advances and New Directions","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129121558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.81104
Mikèl Sanchez, A. Garate, A. M. Bilbao, Jaime Oraá, Fernando Yangüela, P. Sánchez, Jorge Guadilla, B. Aizpurua, J. Azofra, N. Fiz, Diego Delgado
Platelet-rich plasma (PRP) is a biological therapy that uses the patient’s own blood to obtain products with a higher platelet concentration than in blood. It provides a transient fibrin scaffold as a controlled drug delivery system of growth factors suitable for regenerative medicine. PRP has been used as medical strategy to treat diverse types of injuries in the field of orthopedics, including peripheral nerve lesions. In vitro and in vivo studies showed the neuroprotective, neurogenic and neuroinflammatory modulator effect of PRP. In addition, it has been demonstrated clinically that PRP infiltrations improve clinical symptoms and enhance the sensory and motor functional nerve muscle unit recovery. Potential effects of PRP could be applied in treatments for neuropathies, as conservative treatment by means of nerve ultrasound-guided infiltrations or as biological adjuvant during surgery.
{"title":"Platelet-Rich Plasma for Injured Peripheral Nerves: Biological Repair Process and Clinical Application Guidelines","authors":"Mikèl Sanchez, A. Garate, A. M. Bilbao, Jaime Oraá, Fernando Yangüela, P. Sánchez, Jorge Guadilla, B. Aizpurua, J. Azofra, N. Fiz, Diego Delgado","doi":"10.5772/INTECHOPEN.81104","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.81104","url":null,"abstract":"Platelet-rich plasma (PRP) is a biological therapy that uses the patient’s own blood to obtain products with a higher platelet concentration than in blood. It provides a transient fibrin scaffold as a controlled drug delivery system of growth factors suitable for regenerative medicine. PRP has been used as medical strategy to treat diverse types of injuries in the field of orthopedics, including peripheral nerve lesions. In vitro and in vivo studies showed the neuroprotective, neurogenic and neuroinflammatory modulator effect of PRP. In addition, it has been demonstrated clinically that PRP infiltrations improve clinical symptoms and enhance the sensory and motor functional nerve muscle unit recovery. Potential effects of PRP could be applied in treatments for neuropathies, as conservative treatment by means of nerve ultrasound-guided infiltrations or as biological adjuvant during surgery.","PeriodicalId":101960,"journal":{"name":"Demystifying Polyneuropathy - Recent Advances and New Directions","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133709546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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