scholarly journals Evaluation and treatment of peripheral nervous system dysfunction in patients with prediabetes

2021 ◽  
Vol 13 (5) ◽  
pp. 116-122
Author(s):  
O. E. Zinovyeva ◽  
T. M. Ostroumova ◽  
M. V. Koniashova ◽  
N. A. Gorbachev

The worldwide prevalence of prediabetes is steadily increasing, with up to a third of patients already showing signs of diabetic neuropathy (DN). Prediabetes includes impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or a combination of both.Recent diagnostic criteria of prediabetes according to Russian, European, and American clinical guidelines are presented. The review covers the most common forms of DN in patients with prediabetes (distal symmetric sensory polyneuropathy, painful DN, cardiovascular autonomic neuropathy) and their prevalence. Recommended methods of DN screening are discussed: diagnostic scales, sensory testing, nerve conduction study, autonomic testing, corneal confocal microscopy. The results of studies evaluating instrumental methods for diagnosing peripheral nervous system (PNS) dysfunction in prediabetes are discussed. Management tactics in patients with prediabetes and PNS dysfunction should include non-pharmacological and pharmacological interventions. Combining a low-calorie diet and regular physical activity can delay the development of diabetes mellitus and reduce the severity of neuropathic pain. In patients with painful DN, the first-line therapy includes pregabalin, gabapentin, and duloxetine. Since there is no current data on the effect of hypoglycemic therapy on the risks of development and/or progression of DN in patients with prediabetes, antioxidants are considered pathogenetic therapy. Alpha-lipoic acid (Berlition®) in the management of patients with prediabetes is discussed.

2016 ◽  
Vol 21 (6) ◽  
pp. 341-346
Author(s):  
D. Yu Moshkova ◽  
Marina G. Avdeeva

The aim. The prediction of risk degrees of neurological complications in adult patients with erythemal form of borreliosis for the timely appointment of causal and pathogenetic therapy. Materials and methods. We observed 46 patients hospitalized in infectious hospital in Krasnodar in 2013-2014, with a diagnosis of Ixodes tick-borne Lyme disease, erythemal form, acute course was observed in 41 (89.1%) person, subacute - in 2 (4.4%), chronic - 3 (6.5%). In the course of the disease there was studied the level of pro-inflammatory cytokine IFN-y. Results. The average age of patients was 41.1 ± 1.83 years, among them women (63%) dominated. In 31% of patients there were observed symptoms of the damage of the nervous system. From the first week of the disease there was noted a significant increase in the level of IFN-y, which persisted both in the subacute and chronic course of the disease. The average level of IFN-y in patients with signs of the damage of the central and peripheral nervous system accounted for 64.8±14.19 pg/ml being ignificantly higher (P 20.0 pg/ml symptoms of the damage of the nervous system were recorded in 50% of cases. The degrees of neurological complications risk in patients with tick-borne Lyme disease are determined: the IFN-y level of 20.0-34.99 pg/ml predicted the risk of 1 degree (12.5%), level of 35,0-79,99 pg/ml - the risk of 2 degree (45%), the level higher than 80.0pg/ml - the risk of 3 degree (100%). Conclusion. The use of the determination of the IFN-y level can increase the accuracy and provide the timeliness of diagnosis of neurological complications in Lyme borreliosis cases, that is important for the prognosis and treatment of the disease.


Author(s):  
S.S. Spicer ◽  
B.A. Schulte

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.


2000 ◽  
Vol 5 (2) ◽  
pp. 3-3
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage

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.


2004 ◽  
Author(s):  
G. Galietta ◽  
A. Capasso ◽  
A. Fortuna ◽  
F. Fabi ◽  
P. Del Basso ◽  
...  

2019 ◽  
Vol 1 (2) ◽  
pp. 11-14
Author(s):  
O. S. Levin ◽  
O. V. Matvievskaya

The article contains a comprehensive analysis of the summary epidemiological data obtained during the observational study to assess the effect of therapy with Ipigrix® on the dynamics of motor and sensory functions, as well as the severity of pain in outpatient patients with various diseases of the peripheral nervous system: mononeuropathy, polyneuropathy and polyradiculopathy of various origins.


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