• Title/Summary/Keyword: Focal neuropathy

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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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Diabetic Neuropathy (당뇨 신경병증)

  • Shim, Jung-In;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.251-256
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    • 2013
  • Neuropathy is a common complication of diabetes. It is characterized by a progressive loss of peripheral nerve fibers. The development of the neuropathy is linked to poor glycemic control, age, and the duration of diabetes. Peripheral sensory polyneuropathy is the most common type in neuropathy. Diabetic neuropathy is the most significant etiologic factor of the foot ulcer that may leads to amputation. Current treatments in diabetic neuropathy have no definitive effects on repair or reverse the damaged nerve but only to relieve of symptoms, especially on pain. When the focal compressive neuropathy is combined with diabetic neuropathy, the nerve would be more vulnerable and symptoms might get worse. Surgery is indicated for decompression of an entrapped nerve, like posterior tibial nerve in tarsal tunnel, after failure of the initial conservative treatments.

A Case of n-Hexane Induced Neuropathy with Focal Conduction Block (국소적 전도차단을 보인 n-Hexane induced neuropathy 1례)

  • Seo, Wookeun;Park, Beom-Sik;Cho, Seong Jin;Jhun, Hyung-Jun;Koh, Seong-Beom;Kim, Byung-Jo;Park, Jong-Tae;Park, Min-Kyu;Park, Kun-Woo;Lee, Dae-Hie
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.78-80
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    • 2002
  • A 32-year-old man who had worked at aluminum processing plant for 4 months visited us. He complained of numbness and paresthesia of both foot and hands and weakness of all extremities. Electrophysiologic study showed motorsensory polyneuropathy of diffuse axonal type with focal conduction block. And we discovered higher concentration of n-Hexane in his workplace. On sural nerve biopsy, bubbly enlarged nerve fibers in light microscope and thick myelin sheath and axonal degeneration on electron microscope were found. We diagnosed it as n-Hexane induced neuropathy.

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Zoster-associated limb paresis presenting as femoral neuropathy

  • Hwang, Inha;Yun, UnKyu;Bae, Heewon;Han, Jeong Ho;Ha, Sang-Won;Kim, Doo-eung
    • Annals of Clinical Neurophysiology
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    • v.21 no.1
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    • pp.44-47
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    • 2019
  • Zoster-associated limb paresis is a relatively uncommon complication of herpes zoster that is characterized by focal motor weakness. Awareness of this disorder is important to avoid unnecessary invasive investigations and to ensure appropriate treatment. We report a case of a herpes zoster involving the femoral nerve.

Multifocal Motor Neuropathy (다초점성 운동신경병증)

  • Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.4 no.2
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    • pp.98-107
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    • 2002
  • Multifocal motor neuropathy (MMN) is a chronic immune-mediated peripheral myelinopathy. The major clinical features include slowly progressive, painless, and asymmetric weakness, usually of distal limb muscle. Early in the course of the disease, weakness is not necessarily associated with muscle atrophy, owing to the initial primary involvement of peripheral myelin. Chronic progressive weakness is often associated with some degree of concurrent axonal loss and subsequent muscle atrophy. Sensory symptoms are usually mild or absent, and involvement of cranial and respiratory muscles is rare. The findings of multifocal motor conduction block, abnormal temporal dispersion, and focal conduction slowing at segments not at risk for common entrapment or compression injury, associated with normal sensory conduction studies along the same segments, are the hallmark electrophysiologic features of MMN. The slow progression and absence of upper motor neuron signs are the major clinical points that separate MMN from amyotrophic lateral sclerosis. The role of GM1 antibodies, found in high titers in 22~84% of MMN patients, remains uncertain. The contention that MMN is an autoimmune disorder is largely based on the often dramatic improvement in symptoms following the administration of intravenuos immunoglobulin or cyclophosphamide.

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A Case of Lateral Antebrachial Cutaneous Neuropathy (외측 아래팔 피부 신경병증 1예)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.3 no.1
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    • pp.47-49
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    • 2001
  • Lateral antabrachial cutaneous neuropathy(LACN) was diagnosed in a 42-year-old woman who developed pain and paresthesia in the left forearm after several days of heavy labor. The symptoms were resolved with conservative treatment, including cessation of heavy labor and a brief course of oral corticosteroids. But the symptoms recurred after 9 months. Those were also resolved with same treatment as the first attack. LACN is important to recognize because the symptoms may mimic the pathology of a cervical root, the brachial plexus, the radial and median nerves at the level of the elbow, and a focal idiopathic inflammatory neuritis.

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Focal Atrophy of the Unilateral Masticatory Muscles Caused by Trigeminal Neuropathy from the Tumor in the Foramen Ovale

  • Juhyung Hong;Jin-Woo Chung
    • Journal of Oral Medicine and Pain
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    • v.47 no.4
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    • pp.217-221
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    • 2022
  • Neurogenic muscular atrophy is muscle wasting and weakness caused by trauma or disease of the nerve that innervates the muscle. We describe a case of unilateral trigeminal neuropathy and neurogenic muscular atrophy of the masticatory muscle caused by a tumor in the foramen ovale. A 59-year-old man visited our clinic complaining of difficulty in right-sided mastication. There were no evident clinical signs and symptoms of temporomandibular disorder. However, severe atrophy of the right masseter and temporalis muscles and hypesthesia of the right side mandibular nerve area were confirmed. Through T1 and T2 signals on magnetic resonance imaging (MRI), a mass suspected of a neurogenic tumor was observed in the foramen ovale and cavernous sinus. Severe atrophy of all masticatory muscles on the right side was observed. This rare case shows trigeminal neuropathy caused by a tumor around the foramen ovale and atrophy of the ipsilateral masticatory muscles. For an accurate diagnosis, it is essential to identify the underlying cause of muscle atrophy with neurologic symptoms present. This can be done through a more detailed clinical examination, including sensory testing and brain MRI, and consider a referral to neurology or neurosurgery for the differential diagnosis of the intracranial disorder.

A beginner's guide to peripheral nerve ultrasound

  • Seok, Jung Im
    • Annals of Clinical Neurophysiology
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    • v.24 no.2
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    • pp.46-52
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    • 2022
  • Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.

Management of Diabetic Foot Ulcer (당뇨병성 족부 궤양의 치료)

  • Seo, Dong-Kyo;Lee, Ho Seong
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.1
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    • pp.1-7
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    • 2014
  • In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

A Primary Sjögren's Syndrome Patient Presented with Severe General Toothache

  • Lee, Yeon-Hee;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.40 no.3
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    • pp.130-134
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    • 2015
  • $Sj{\ddot{o}}gren's$ syndrome (SS) is an autoimmune disease characterized by an autoimmune exocrinopathy involving mainly salivary and lacrimal glands. Apart from manifestations due to involvement of exocrine glands, patients with SS can present with muscular and neurological manifestations. Here, we report a rare case of a 59-year-old woman with primary SS, who presented with severe general toothache and masticatory muscle myalgia successfully treated with clonazepam. Although it was not certain that these symptoms could be originated from focal muscle dystonia or neurological changes that are associated with primary SS, our case suggested that comprehensive evaluation including neuromuscular examinations in the oral and maxillofacial area is needed in patients with SS.