scholarly journals Electrophysiological Evaluation of Peripheral and Autonomic Involvement in Leprosy

2004 ◽  
Vol 31 (3) ◽  
pp. 357-362 ◽  
Author(s):  
Aysun Soysal ◽  
Turan Atay ◽  
Tacettin Ozu ◽  
Baki Arpaci
Keyword(s):  
Sensory Nerve ◽  
Sympathetic Skin Response ◽  
Lepromatous Leprosy ◽  
Control Group ◽  
Evaluation Standard ◽  
Standard Procedures ◽  
Skin Response ◽  
Leprosy Patients ◽  
Skin Responses ◽  
Sympathetic Skin Responses

Objective:Motor and sensory nerve conductions, F responses, sympathetic skin responses and R-R interval variations (RRIV) were studied to determine the type of peripheral neuropathy among patients with leprosy.Methods:Twenty-nine consecutive patients with leprosy (25 male, 4 female) hospitalized in the “Istanbul Leprosy Hospital'' between January - December, 1999 were included in this study. Ten patients had borderline lepromatous leprosy, and 19 had lepromatous leprosy. None of the patients studied had the tuberculoid form. The mean age was 55±12 years. The control group consisted of 30 (26 male, 4 female) healthy volunteers (mean age: 58.1±7.8 years). All subjects included in the study underwent neurological examination and electrophysiological evaluation. Standard procedures were performed for evaluating sensory and motor conduction studies. Motor studies were carried out on both left and right median, ulnar, tibial and common peroneal nerves while median, ulnar, sural and superficial peroneal nerves were examined for sensory studies. Sympathetic skin response recordings on both hands and RRIV recordings on precordial region were done in order to evaluate the autonomic involvement.Results:The lower extremity was found to be more severely affected than the upper, and sensory impairment predominated over motor. Of 58 upper limbs examined, no sympathetic skin responses was recorded in 46 (79.3%). Compared with the controls, the RRIVs of the leprosy patients were found to be reduced during both resting and deep forced hyperventilation.Conclusion:Our results indicate that leprosy causes a predominantly axonal polyneuropathy that is more severe in the lower extremities. Sensory nerve damage is accompanied by autonomic involvement.

Evaluation of interictal autonomic function during attack and remission periods in cluster headaches

Cephalalgia ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Ozlem Altiokka ◽  
Belgin Mutluay ◽  
Ayhan Koksal ◽  
Beyza Ciftci-Kavaklioglu ◽  
Musa Ozturk ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Orthostatic Hypotension ◽  
Sympathetic Skin Response ◽  
Skin Response ◽  
The Face ◽  
Skin Responses ◽  
Cluster Headaches ◽  
Drug Free ◽  
Headache Patients ◽  
Sympathetic Skin Responses

Objective To investigate which part of the autonomic system is mainly involved and assess the sensitivity of face sympathetic skin response in cluster headache. Material and methods The study sample consisted of 19 drug-free cluster headache patients (16 males, three females) and 19 healthy volunteers. Demographic features and pain characteristics were thoroughly identified. Dysautonomic symptoms were evaluated during attack and remission periods of cluster headache patients. Orthostatic hypotension, R-R interval variation and sympathetic skin responses obtained from the face and four extremities were evaluated and the sensitivity of face sympathetic skin responses was assessed in contrast to extremity sympathetic skin responses. Results All sympathetic skin responses of face and extremities could be obtained during attack and remission periods. On the symptomatic side, mean latency of face sympathetic skin responses was longer compared to the asymptomatic side and controls (p = 0.02, p = 0.004). There were no differences in latency or amplitude of extremity sympathetic skin responses between symptomatic and asymptomatic sides and controls. No significant relationship was determined between sympathetic skin responses, R-R interval variation, orthostatic hypotension and cluster headache clinical features. Conclusion Sympathetic hypoactivity of the face seems to predominate the pathophysiology of cluster headache. Face sympathetic skin responses might be more sensitive compared to extremity sympathetic skin response in demonstrating dysautonomic symptoms in cluster headache patients.

scholarly journals Role of Urinary Calcium and Creatinine Ratio in Assessing Bone Resorption in Lepromatous Leprosy

2021 ◽  
Vol 48 (3) ◽  
pp. 28-33
Author(s):  
Saima Akhter ◽  
Md Qamrul Hassan Jaigirdar ◽  
Md Mostaque Mahmud ◽  
Shawana Haque ◽  
Rahat Bin Habib
Keyword(s):  
Bone Resorption ◽  
Lepromatous Leprosy ◽  
Urinary Calcium ◽  
Control Group ◽  
X Rays ◽  
Creatinine Ratio ◽  
Leprosy Patients ◽  
Healthy Control ◽  
Hands And Feet

Bony changes in lepromatous leprosy are one of the causes of deformity and disability. Fasting calcium and creatinine ratio in urine is used as a bone resorption marker in a number of diseases such as hyperthyroidism, osteoporosis, multiple myeloma, paget’s disease and sarcodosis. In lepromatous leprosy assessment of bone resorption might be done with that marker. To assess the role of fasting urinary calcium and creatinine ratio as a marker of bone resorption in patients with lepromatous leprosy. A case control study was conducted on 28 patients diagnosed as lepromatous leprosy and 28 age-matched healthy control. The participants who fulfilled all inclusion and exclusion criteria were studied by measuring fasting urinary calcium and creatinine level as well as observing X-rays of both hands and feet of affected individuals. The mean age of cases 38.1±14.2 years and 38.9±12.9 years was in control group. Male - female ratio was 3.6: 1. It was observed that 10.7% leprosy patients showed urinary Ca/Cr ratio >0.20 (0.13±0.12) and 10.7% healthy control showed urinary Ca/Cr ratio ratio>0.20 (mean ±SD 0.11±0.7). the difference was not statistically significant (p>0.05). X-ray finding was positive in 14.3% leprosy patients and none of the control group. That difference was not significant statistically (p>0.05). there was no relation between raised urinary Ca/Cr ratio and positive findings of bone resorption on x-rays among the leprosy cases. Bangladesh Med J. 2019 Sep; 48 (3): 28-33

scholarly journals Evaluation of Autonomic Nervous System in Children With Cerebral Palsy: Clinical and Electophysiological Study

2021 ◽  
Author(s):  
Hanan Galal Azouz ◽  
Ali M Abdel Mohsen ◽  
Rana M Mohamed ◽  
hayam mostafa abdelghany
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cerebral Palsy ◽  
Autonomic Dysfunction ◽  
Sympathetic Skin Response ◽  
Spastic Cerebral Palsy ◽  
Control Group ◽  
Healthy Children ◽  
Children With Cerebral Palsy ◽  
Skin Response

Abstract Cerebral palsy (CP) is the most prevalent severe motor disability among children. The aim of this work was to assess autonomic dysfunction in children with cerebral palsy clinically and electrophysiologically .The study was carried out on forty children with cerebral palsy their age ranged from 4-12 years and twenty healthy children with matched age and sex as control group. CP children were subjected to questionnaire for autonomic dysfunction symptoms. Both CP children and Control group were assessed for Sympathetic Skin Response and Heart rate variability. Most of children had quadriplegic spastic cerebral palsy (82.5%). Based on Gross motor function classification system (GMFCS) classification the majority of children were in levels 4 and 5. The prevalence of autonomic dysfunction symptoms was 80% for thermoregulatory abnormalities (cold extremities), chronic constipation 65%, sleep disturbance 52.5%, loss of appetite 47.5%, sweating abnormalities 40% , recurrent nausea and/or vomiting 25%, increased sensitivity to light or dark 22.5% and bloating 15%. The percentage of unelicited Sympathetic skin response in CP children was 47.5% and 60% in upper limbs and lower limbs respectively, all of them were in level 4 and 5 of GMFCS. 20% of CP children had postural hypotension. Mean Heart rate of CP children was significantly increased more than healthy children upon head tilt test. Sympathetic Skin Response and Heart rate variability were proven to be simple and non invasive procedures in investigating autonomic dysfunction in CP children.

scholarly journals Electrophysiological investigation for autonomic dysfunction in patients with myasthenia gravis : A prospective study

2021 ◽  
Vol 74 (1-2) ◽  
pp. 33-40
Author(s):  
Mecbure Nalbantoglu ◽  
Mehmet Ali Akalin ◽  
Aysegul Gunduz ◽  
Meral Kiziltan
Keyword(s):  
Myasthenia Gravis ◽  
Autonomic Dysfunction ◽  
Acetylcholinesterase Inhibitors ◽  
Sympathetic Skin Response ◽  
Autoimmune Disorder ◽  
Control Group ◽  
Negative Group ◽  
Achr Antibody ◽  
Skin Response ◽  
A Prospective Study

Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors. This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment. The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033). The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.

scholarly journals Thyroid functional status in leprosy patients in Sudan

2001 ◽  
Vol 7 (1-2) ◽  
pp. 79-83
Author(s):  
M. M. Kheir
Keyword(s):  
Functional Status ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Lepromatous Leprosy ◽  
Adult Patients ◽  
Control Group ◽  
Normal Range ◽  
Serum Thyroxine ◽  
Biochemical Effects ◽  
Leprosy Patients

Westudied 45 adult patients with untreated lepromatous leprosy and borderline leprosy, presenting at clinics in Khartoum and Omdurman, to assess clinical and biochemical effects of the disease on thyroid function. A matching control group of 30 subjects, without symptoms or signs of thyroid disease, were included for comparison. Thyroxine, triiodothyronine and thyrotrophin levels were within normal range. Mean serum thyroxine was low in both groups [significant in lepromatous leprosy patients only]. Mean serum triiodothyronine was high in both groups [significant in neither group]. Mean thyrotrophin was significantly higher in both groups compared with controls.

scholarly journals Is There Any Sympathetic Skin Response (SSR) Abnormality in Raynaud Phenomenon?

2021 ◽  
Author(s):  
Mohammad R. Emad ◽  
Hamid R. Farpour ◽  
Faisal Ahmed ◽  
Masoumeh Tayebi ◽  
Mohammadali Nazarinia ◽  
...  
Keyword(s):  
Raynaud’S Phenomenon ◽  
Sympathetic Skin Response ◽  
Raynaud's Phenomenon ◽  
Sympathetic System ◽  
Control Group ◽  
Raynaud Phenomenon ◽  
Unmyelinated Axons ◽  
Skin Response ◽  
The Mean ◽  
And Control

Objectives: Sympathetic skin response (SSR) is a technique for assessment of the damage of peripheral neuropathies and the disorders of the sympathetic system. This study aimed to evaluate SSR among patients with Raynaud phenomenon (RP). Methods: Between January 1, 2015 and December 30, 2018, about 20 patients with RP and 20 healthy subjects as the control group were recruited from patients referring to the Outpatient Clinics of Shiraz medical University. All the participants were clinically examined, and the SSR was performed using a standard protocol. SSR is abnormal when the latency is prolonged and/or the amplitude reduced. Results: Raynaud's group consisted of 19 women (95 %) and 1 male (5%). 3 patients (15 %) with primary Raynaud's phenomenon (PRP) and 17 patients (85%) with secondary Raynaud's phenomenon (SRP). The control group consisted of 16 women (80%) and 4 males (20%). The mean age of the Raynaud's group and control subjects was 43.1±9 and 36.7±8.6 years, respectively. The SSR to the electrical stimulus was absent in 3 patients (PRP patients). The total median nerve mean latencies in the upper limb were 1.9±0.57 and 1.19±0.52 seconds for the Raynaud's group and control groups, respectively (p <0.001). These findings revealed significantly prolonged SSR latencies in the Raynaud's group, while the mean amplitude showed no significant differences in both groups (p =0.756). Conclusion: Absence or prolonged latency of SSR was associated with the disorders of the unmyelinated axons in the sympathetic system. Our findings suggested the disorders of unmyelinated axons in Raynaud's phenomenon. Keywords: Raynaud Disease; Autonomic Nervous System; Electrodiagnosis; Sympathetic Fibers; Nerve Conduction.

scholarly journals High rate of autonomic neuropathy in Cornelia de Lange Syndrome

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
M. J. Pablo ◽  
P. Pamplona ◽  
M. Haddad ◽  
I. Benavente ◽  
A. Latorre-Pellicer ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Sensory Nerve ◽  
Sympathetic Skin Response ◽  
Premature Aging ◽  
High Rate ◽  
Cornelia De Lange Syndrome ◽  
Autonomic Nervous ◽  
Skin Response ◽  
Cornelia De Lange

Abstract Background Cornelia de Lange Syndrome (CdLS) is a rare congenital disorder characterized by typical facial features, growth failure, limb abnormalities, and gastroesophageal dysfunction that may be caused by mutations in several genes that disrupt gene regulation early in development. Symptoms in individuals with CdLS suggest that the peripheral nervous system (PNS) is involved, yet there is little direct evidence. Method Somatic nervous system was evaluated by conventional motor and sensory nerve conduction studies and autonomic nervous system by heart rate variability, sympathetic skin response and sudomotor testing. CdLS Clinical Score and genetic studies were also obtained. Results Sympathetic skin response and sudomotor test were pathological in 35% and 34% of the individuals with CdLS, respectively. Nevertheless, normal values in large fiber nerve function studies. Conclusions Autonomic nervous system (ANS) dysfunction is found in many individuals with Cornelia de Lange Syndrome, and could be related to premature aging.

Abnormalities of the sympathetic skin response in lepromatous leprosy

1996 ◽  
Vol 19 (10) ◽  
pp. 1357-1358 ◽  
Author(s):  
Theodore R. Brown ◽  
Apichana Kovindha ◽  
Ubonwon Wathanadilokkol ◽  
Trevor Smith ◽  
George H. Kraft
Keyword(s):  
Sympathetic Skin Response ◽  
Lepromatous Leprosy ◽  
Skin Response

scholarly journals BCG vaccination of children against leprosy in Uganda: final results

1981 ◽  
Vol 87 (2) ◽  
pp. 233-248 ◽  
Author(s):  
Susan J. Stanley ◽  
C. Howland ◽  
M. Mary Stone ◽  
I. Sutherland
Keyword(s):  
Protective Effect ◽  
Controlled Trial ◽  
Lepromatous Leprosy ◽  
Physical Contact ◽  
Control Group ◽  
Percentage Reduction ◽  
Bcg Vaccination ◽  
Unvaccinated Control ◽  
Leprosy Patients

SummaryA total of 19200 children, all contacts or relatives of known leprosy patients, and all free of visible leprosy lesions, were included in a controlled trial of BCG vaccination against leprosy in Uganda between 1960 and 1964. They were followed for an average of 8 years, during which time 261 developed early leprosy lesions. A less comprehensive follow-up was carried out for a further 5 years, when 8 more cases of leprosy were identified.In the main intake, between 1960 and 1962, 16150 tuberculin-negative or weakly tuberculin-positive (Heaf Grades O-II) children were allocated by an effectively random process to either a BCG-vaccinated or an unvaccinated control group. Both groups were seen and examined in an identical fashion for leprosy at approximately 2-year intervals, and precautions were taken to ensure unbiased assessment of new cases of leprosy. After 8 years, 41 cases of leprosy had been identified in the BCG-vaccinated group, and 201 in the control group, a percentage reduction in the BCG-vaccinated group compared with the control group of 80%. The percentage reduction was similar for those initially tuberculin-negative, and for those initially weakly positive, and did not depend upon the age at vaccination. It was also similar for both sexes, for contacts of lepromatous and contacts of non-lepromatous leprosy, for children having contact with one or more than one patient, and for differing grades of physical contact and genetic relationship with a patient. The protective effect of BCG vaccination continued over the 8-year period, although it may have fallen off slightly at the end.In a group of 1074 strongly tuberculin-positive (Heaf Grades III-IV) children followed in parallel with the other two groups a total of 16 cases of leprosy were identified. When adjusted for age, this incidence is 58% lower than that in the unvaccinated control children who were initially tuberculin-negative, indicating a protective effect against leprosy of naturally-acquired strong tuberculin sensitivity.Between 1970 and 1975, one new case of leprosy was identified in a child who had initially been strongly tuberculin-positive and had therefore not been vaccinated, one in a BCG-vaccinated child, and 6 in control children. Although the follow-up in this period was less comprehensive than that in the main part of the trial, the ascertainment of cases was unlikely to have been biased towards either vaccinated or control children. These results indicate a continuing protective effect of BCG up to 12–13 years after vaccination.

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