Effects of Spontaneous Chronic Hypoglycemia on Central and Peripheral Nervous System in Insulinoma Patients before and after Surgery: A Neurophysiological Follow-Up

Abstract Purpose To examine long-term alterations of the dorsal root ganglia (DRG) and the peripheral nerve in patients with neurofibromatosis type 2 (NF2) by in vivo high-resolution magnetic resonance neurography (MRN) and their correlation to histology. Methods In this prospective study the lumbosacral DRG, the right sciatic, tibial, and peroneal nerves were examined in 6 patients diagnosed with NF2 and associated polyneuropathy (PNP) by a standardized MRN protocol at 3 T. Volumes of DRG L3–S2 as well as peripheral nerve lesions were assessed and compared to follow-up examinations after 14–100 months. In one patient, imaging findings were further correlated to histology. Results Follow-up MRN examination showed a non-significant increase of volume for the DRG L3: +0.41% (p = 0.10), L4: +22.41% (p = 0.23), L5: +3.38% (p = 0.09), S1: +10.63% (p = 0.05) and S2: +1.17% (p = 0.57). Likewise, peripheral nerve lesions were not significantly increased regarding size (2.18 mm2 vs. 2.15 mm2, p = 0.89) and number (9.00 vs. 9.33, p = 0.36). Histological analyses identified schwannomas as the major correlate of both DRG hyperplasia and peripheral nerve lesions. For peripheral nerve microlesions additionally clusters of onion-bulb formations were identified. Conclusion Peripheral nervous system alterations seem to be constant or show only a minor increase in adult NF2. Thus, symptoms of PNP may not primarily attributed to the initial schwannoma growth but to secondary long-term processes, with symptoms only occurring if a certain threshold is exceeded. Histology identified grouped areas of Schwann cell proliferations as the correlate of DRG hyperplasia, while for peripheral nerve lesions different patterns could be found.

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Factor VIII prophylactic therapy reduces neurological complications in patients with Hemophilia A

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0467 ◽

2021 ◽

Author(s):

José Marcelino Aragão FERNANDES ◽

Francisco de Assis Aquino GONDIM ◽

Antônia Maria Negreiro DIAS ◽

Rosângela de Albuquerque RIBEIRO ◽

Luiz Ivando Pires FERREIRA FILHO ◽

...

Keyword(s):

Nervous System ◽

Factor Viii ◽

Peripheral Nervous System ◽

Intracranial Hemorrhage ◽

Prophylactic Treatment ◽

Hemophilia A ◽

Neurological Complications ◽

Prophylactic Therapy ◽

First Report ◽

Before And After

ABSTRACT Background: Bleeding in hemophiliacs can cause complications in the central and peripheral nervous system (CNS and PNS). The incidence of intracranial hemorrhage has reduced after the introduction of prophylactic treatment with factor VIII or IX, but the benefits of this therapy have not yet been evaluated on PNS complications. Objective: The aim of this study was to determine the prevalence of neurological complications in hemophiliacs and verify the effect of prophylactic therapy in these patients, including PNS disorders. Methods: We retrospectively evaluated the prevalence of CNS and PNS disorders caused by bleeding in hemophiliacs seen at the Hemocentro Regional Norte, Ceará, Brazil, from 1992 to 2018, and we compared the incidence in different periods (before and after the introduction of prophylactic treatment in 2011). Results: Of 75 hemophilia A patients evaluated (4.61/100.000 population), 13.3% (n=10) had either CNS (n=5) or PNS (n=5) disorders secondary to bleeding. Patients submitted to factor VIII replacement prophylactic therapy were less likely to have CNS events: from 1992 to 2011, 5 of 63 patients had CNS disease, while from 2011 to 2018, there were no new cases (p=0.0181). From 2011 to 2018, 5 PNS events occurred in patients without prophylactic therapy, whereas none occurred in those covered by prophylactic therapy (5/20 versus 0/29, p=0.0081). Conclusions: The prevalence of neurological complications in hemophiliacs in our cohort is similar to other studies. Similar to CNS, prophylactic therapy also reduces the risk of PNS complications. This is the first report in the literature showing this benefit.

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What Can Be Learned on the Effects on the Peripheral Nervous System of Lifetime Exposure to Organophosphates? A Four-Decade Follow-Up

ISEE Conference Abstracts ◽

10.1289/isee.2014.p1-225 ◽

2014 ◽

Vol 2014 (1) ◽

pp. 2224

Author(s):

Isabella Karakis* ◽

Amit Ophir ◽

Eliyaho Richter ◽

Jerry Abarbanel ◽

Wormser Uri ◽

...

Keyword(s):

Nervous System ◽

Peripheral Nervous System ◽

Lifetime Exposure

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TREATMENT WITH STATINS AND INVOLVEMENT OF THE PERIPHERAL NERVOUS SYSTEM: RESULTS OF A PROSPECTIVE CLINICAL AND NEUROPHYSIOLOGICAL FOLLOW-UP

Biomedical Papers ◽

10.5507/bp.2007.052 ◽

2007 ◽

Vol 151 (2) ◽

pp. 307-310 ◽

Cited By ~ 6

Author(s):

Pavel Otruba ◽

Petr Kanovsky ◽

Petr Hlustik

Keyword(s):

Nervous System ◽

Peripheral Nervous System

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Glucuronyl 3-sulfate occurs exclusively on distal unmyelinated terminals of selected sensory neurons in the peripheral nervous system

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100141160 ◽

1995 ◽

Vol 53 ◽

pp. 958-959

Author(s):

S.S. Spicer ◽

B.A. Schulte

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Cerebral Cortex ◽

Peripheral Nervous System ◽

Sensory Neurons ◽

Sensory Nerves ◽

Tissue Antigens ◽

The Central Nervous System ◽

The Brain ◽

Leu 7

Generation of monoclonal antibodies (MAbs) against tissue antigens has yielded several (VC1.1, HNK- 1, L2, 4F4 and anti-leu 7) which recognize the unique sugar epitope, glucuronyl 3-sulfate (Glc A3- SO4). In the central nervous system, these MAbs have demonstrated Glc A3-SO4 at the surface of neurons in the cerebral cortex, the cerebellum, the retina and other widespread regions of the brain.Here we describe the distribution of Glc A3-SO4 in the peripheral nervous system as determined by immunostaining with a MAb (VC 1.1) developed against antigen in the cat visual cortex. Outside the central nervous system, immunoreactivity was observed only in peripheral terminals of selected sensory nerves conducting transduction signals for touch, hearing, balance and taste. On the glassy membrane of the sinus hair in murine nasal skin, just deep to the ringwurt, VC 1.1 delineated an intensely stained, plaque-like area (Fig. 1). This previously unrecognized structure of the nasal vibrissae presumably serves as a tactile end organ and to our knowledge is not demonstrable by means other than its selective immunopositivity with VC1.1 and its appearance as a densely fibrillar area in H&E stained sections.

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Stimulating Swallowing: Essential Central and Peripheral Nervous System Targets

ASHA Leader ◽

10.1044/leader.ftr1.16092011.10 ◽

2011 ◽

Vol 16 (9) ◽

pp. 10-13 ◽

Cited By ~ 3

Author(s):

Ianessa A. Humbert

Keyword(s):

Nervous System ◽

Peripheral Nervous System

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Questions and Answers

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.marapr02 ◽

2000 ◽

Vol 5 (2) ◽

pp. 3-3

Author(s):

Christopher R. Brigham ◽

James B. Talmage

Keyword(s):

Nervous System ◽

Peripheral Nervous System ◽

Spinal Nerve ◽

Sensory Loss ◽

Residual Symptoms ◽

Additional Information ◽

Questions And Answers ◽

Motor Nerves ◽

Symptoms And Signs ◽

Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

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