• Annals of Clinical Neurophysiology
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• v.7 no.1
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• pp.17-19
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• 2005

Polyneuropathy that is associated with monoclonal gammopathy of undetermined significance (MGUS) similar to chronic inflammatory demyelinating polyneuropathy (CIDP) has been reported before, whereas a connection to acute inflammatory demyelinating polyneuropathy (AIDP) has not been. A 52 year-old man was presented with ascending paralysis beginning 1 day ago. Neurological examinations showed facial diplegia and decreased motor power and deep tendon reflexes in all extremities. On electrophysiologic study, sensorimotor polyneuropathy was observed. Protein-and immunoelectrophoresis revealed IgA $\lambda$ monoclonal gammopathy. High dose steroid therapy was given and the symptoms improved slightly.

• 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.

• 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.

• Annals of Clinical Neurophysiology
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• v.13 no.2
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• pp.97-100
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• 2011

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated polyneuropathy. Corticosteroids, intravenous immunoglobulin (IVIG) and plasmapheresis have been reported to be effective treatment. Rarely, CIDP can occur in the patients with HIV infection. The clinical features and electrophysiological findings of CIDP are known to be similar in patients with and without HIV infection. We report a 30-year-old male with HIV infection associated CIDP who improved after the administration of intravenous immunoglobulin and long term oral prednisone.

• 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.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.329-332
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• 2018

Immune checkpoint inhibitor is associated with variety of immune-related adverse events. We present a case of polyneuropathy induced by immune checkpoint inhibitor, which was refractory to steroid and immunoglobulin. While high-dose steroid and immunoglobulin were not effective, we tried rituximab which is effective in other immune-mediated polyneuropathy. After rituximab treatment, patient's clinical symptom and nerve conduction study finding was markedly improved. We suggest rituximab might be effective in polyneuropathy induced by immune checkpoint inhibitor.

• Journal of Sasang Constitutional Medicine
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• v.35 no.4
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• pp.55-64
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• 2023

Objectives This study was aimed to report improvement of Soeumin patient diagnosed with Alcoholic Polyneuropathy using Hyangbujapalmul-tang. Method The 41-year-old man had severe foot pain, sensory slow down and ataxic gait. The patient was diagnosed Soeumin and medicated with Hyangbujapalmul-tang three times a day. Clinical improvement was evaluated with blood test, ataxic gait evaluation, deep tendon reflex and visual analogue scale (VAS). Results The symptoms of foot pain, sensory slow down and ataxic gait were dramatically improved after treatment. Conclusions Constitutional treatment for foot pain, sensory slow down and ataxic gait diagnosed with Alcoholic Polyneuropathy are potentially effective.

• Annals of Clinical Neurophysiology
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• v.5 no.1
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• pp.34-38
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• 2003

Backgrounds and Objectives: In the length-dependent axonal polyneuropathy like diabetic polyneuropathy (DPN), the distal part of the longer axons are affected earlier. In cases of minimal distal axonal changes, nerve conduction studies (NCS) are frequently normal. If sural nerve is affected in the early stage of DPN, supportive parameters to detect the early axonal degeneration may be helpful. We investigated whether the sural/ulnar SNAP amplitude ratio (SUAR) may be a more sensitive indicator than sural amplitude alone in the diagnosis of early diabetic polyneuropathy. Methods: We analyzed medical records and electrophysiological studies of 141 patients with DM and 30 healthy subjects. The patients with early stage of DPN were defined as those having symptoms of neuropathy and normal NCS findings among the patients with DM. We compared SUAR between 57 patients with early stage of DPN and 71 agematched control subjects. Results: Fifty seven patients had an average SUAR of 0.8, compared to that of 1.1 in the 71 normal controls. The SUAR of less than 0.9 was supplementary predictor of axonal polyneuropathy, with the best balance of sensitivity and specificity (70%). The SUAR did not vary significantly with age, height or duration of DM. Conclusions: We conclude that the SUAR is a useful electrodiagnostic indicator to detect early stage of DPN.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.97-100
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• 2005

Background: The most distal sensory fibers of the feet are often affected first in polyneuropathy. However, they are not evaluated in routine nerve conduction studies. Thus we evaluated the dorsal sural sensory nerve in patients with sensorimotor polyneuropathy with normal sural response, in order to assess the usefulness in electrodiagnostic practice. Methods: In this study, 53 healthy subjects and 27 patients with clinical evidence of sensorimotor polyneuropathy were included. In all subjects, peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. On electrodiagnostic testing, all patients had normal sural responses. Results: The dorsal sural sensory nerve action potentials (SNAPs) mean amplitude was $13.12{\pm}5.68{\mu}V$, mean latency was $3.12{\pm}0.43msec$, and mean sensory conduction velocity (SCV) was $36.50{\pm}3.40m/s$ in healthy subjects. In 7 of 27 patients, the dorsal sural nerve SNAPs were absent bilaterally, and in 20 patients, the mean dorsal sural nerve distal latency was longer($3.40{\pm}0.48ms$, P=0.006), and mean SCV was slower than in healthy subjects($35.08{\pm}4.59$, P=0.043). However, dorsal sural nerve amplitude was not different between the groups (P=0.072). Conclusions: Our findings suggest that dorsal sural nerve conduction studies should be included in the routine electrodiagnostic evaluation of patients with suspected polyneuropathy and normal sural nerve responses.

• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.21-26
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• 2010

Background: Although quantitative sensory test (QST) is being used with increasing frequency for measuring sensory thresholds in clinical practice and epidemiologic studies, there has been no age-matched normative data in Korean adults. The objective of this study is to evaluate the value of QST in diabetic polyneuropathy with normal range in Korean adults. Methods: The Computer Aided Sensory Examination IV 4,2 (WR Medical Electronics Co., Stillwater, Minnesota, U.S.A.), with 4,2,1 stepping algorithm was used to determine vibration and cold perception threshold in 70 normal controls and 19 patients with diabetic polyneuropathy aged from 21 to 79 years. The data were used to define age-matched upper and lower normal limits and normal range of side to side difference. We also evaluated the duration of diabetes, serum HbA1C level, and findings of nerve conduction study (NCS) and QST in patients with diabetic polyneuropathy. Results: In normal adults, sensory thresholds slightly increased with age, and a slight side-to-side difference was observed. The diagnostic sensitivity of QST was not higher than NCS in patients with diabetic polyneuropathy (36.8% vs. 42.1%, p=0.716), especially among elderly patients. Conclusions: QST might be used as a complementary test for NCS in the diagnosis of diabetic polyneuropathy. Although the QST is a simple method for the evaluation of peripheral nerve function, there are some limitations. Most of all, because the QST measuring is dependent on the subjective response of patients, the degree of concentration and cooperation of the patients can significantly affect the result. And thus, attention should be paid during the interpretation of QST results in patients with peripheral neuropathy.