Chronic inflammatory demyelinating polyneuropathy presenting with autonomic symptoms: a case report

A 31 year old female presented with a one-year history of burning sensations, numbness and tingling feelings in her hands and feet. There was also excessive sweatiness of her hands and feet while experiencing these symptoms. Her symptoms were worse at night and during hot weather conditions and aggravated by contact with light clothing. She could not tolerate her shoes. She also complained of weakness in her distal lower limbs. Examination revealed prominent wasting of the thenar and hypothenar eminences, marked bilateral weakness of hand grip, palmar, and dorsal interossei. There was also the significant weakness of the dorsiflexor of the feet with allodynia. Vibration and joint position sense were impaired in the distal lower limbs. Ankle reflexes were diminished. Nerve conduction studies showed nerve conduction block in three nerves. She also had abnormalities from motor and sensory nerve conduction studies involving multiple nerves. She showed remarkable improvements in her symptoms after a course of pulsed oral dexamethasone therapy.

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Monoclonal Gammopathy Presenting as Peripheral Neuropathy

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47090.14800 ◽

2021 ◽

Author(s):

Vishaka Agarwal ◽

Koukutla Soundarya Rajeshwari ◽

KT Jayakumar ◽

. Satish ◽

Chetan Somu

Keyword(s):

Upper Limb ◽

Lower Limb ◽

Chronic Inflammatory Demyelinating Polyneuropathy ◽

Position Sense ◽

Joint Position Sense ◽

Lower Limbs ◽

Foot Drop ◽

Thigh Muscle ◽

Upper Limbs ◽

Long Duration

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations, autoimmune disorders, to vasculitis and malignancies. Hereby, authors report a case of a male patient who presented with complains of bilateral lower limb numbness and weakness, and bilateral upper limb numbness, since two months, which was gradually progressive. On examination, he was found to have muscle wasting in his bilateral upper limb web spaces, left anterior thigh muscle, decreased tone in bilateral upper limbs and lower limbs, decreased power in both his upper limbs distally and decreased power in both his lower limbs (distal>>proximal) was seen. Superficial reflexes were normal with bilateral plantar being equivocal. Deep tendon reflexes were absent in bilateral upper and lower limbs. Tremors of bilateral upper limbs on extension were present. Loss of vibration sense throughout, loss of joint position sense at bilateral big toe and ankle joint and foot drop of his left lower limb were noticed. A diagnosis of CIDP with underlying plasma cell disorder was made after serum electrophoresis, immune-fixation and electrodiagnostic studies. The patient was started on prednisone 60 mg once daily, discharged and advised for monthly follow-up. Diagnosis of CIDP and the underlying cause is multifactorial, which can be misdiagnosed, presenting as a challenge. Hence, a detailed clinical examination, appropriate investigations are very crucial in diagnosing and treating a case of CIDP and its underlying cause. Treatment includes glucocorticoids like prednisone, IV Ig (Intravenous Immunoglobulin), plasma exchange, treating the underlying cause.

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Reproducibility of sensory nerve conduction studies of the sural nerve using ultrasound-guided needle positioning

Muscle & Nerve ◽

10.1002/mus.22182 ◽

2011 ◽

Vol 44 (6) ◽

pp. 873-876 ◽

Cited By ~ 6

Author(s):

Olivier Scheidegger ◽

Alexander F. Küffer ◽

Christian P. Kamm ◽

Kai M. Rösler

Keyword(s):

Nerve Conduction ◽

Sural Nerve ◽

Sensory Nerve ◽

Nerve Conduction Studies ◽

Ultrasound Guided

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Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000100017 ◽

2009 ◽

Vol 67 (1) ◽

pp. 69-73 ◽

Cited By ~ 8

Author(s):

Dante Guilherme Velasco Hardoim ◽

Guilherme Bueno de Oliveira ◽

João Aris Kouyoumdjian

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Sensory Nerve ◽

Nerve Conduction Studies ◽

Sensory Nerve Action ◽

Tunnel Syndrome ◽

The Mean ◽

Compound Action

OBJECTIVE: To compare a long-term carpal tunnel syndrome (CTS) on nerve conduction studies (NCS) in hands treated non-surgically. METHOD: We retrospectively selected 261 symptomatic CTS hands (166 patients), all of them confirmed by NCS. In all cases, at least 2 NCS were performed in an interval greater than 12 months. Cases with associated polyneuropathy were excluded. NCS parameters for CTS electrodiagnosis included a sensory conduction velocity (SCV) <46.6 m/s (wrist to index finger, 14 cm) and distal motor latency (DML) >4.25 ms (wrist to APB, 8 cm). RESULTS: 92.8% were women; mean age was 49 years (20-76); the mean interval between NCS was 47 months (12-150). In the first exam, the median sensory nerve action potential (SNAP) and the compound action muscular potential were absent in 9.8% and 1.9%, respectively. In the second/last exam, SCV worsened in 54.2%, remained unchanged in 11.6% and improved in 34.2%. SNAP amplitude worsened in 57.7%, remained unchanged in 13.1% and improved in 29.2%. DML worsened in 52.9%, remained unchanged in 7.6% and improved in 39.5%. Overall, NCS parameters worsened in 54.9%, improved in 34.3% and remained unchanged in 10.8%. CONCLUSION: Long-term changing in NCS of CTS hands apparently were not related to clinical symptomatology and could lead to some difficulty in clinical correlation and prognosis. Aging, male gender and absent SNAP were more related to NCS worsening, regardless the mean interval time between the NCS.

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PO1.5 Medial Plantar Sensory Nerve Conduction Studies in Diabetics; Comparisons of Three Different Methods

Clinical Neurophysiology ◽

10.1016/s1388-2457(09)60094-8 ◽

2009 ◽

Vol 120 ◽

pp. S34

Author(s):

Hyuk Hwan Kwon ◽

Dong Kuck Lee ◽

Jung Im Seok ◽

Woo Ho Han

Keyword(s):

Nerve Conduction ◽

Sensory Nerve ◽

Nerve Conduction Studies

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Cannabis and the Peripheral Nervous System

The British Journal of Psychiatry ◽

10.1192/bjp.131.4.361 ◽

1977 ◽

Vol 131 (4) ◽

pp. 361-365 ◽

Cited By ~ 3

Author(s):

M. Dibenedetto ◽

H. B. McNamee ◽

J. C. Kuehnle ◽

J. H. Mendelson

Keyword(s):

Nervous System ◽

Peripheral Nervous System ◽

Nerve Conduction ◽

Sensory Nerve ◽

Baseline Period ◽

Nerve Conduction Studies ◽

Nerve Function ◽

Heavy Users ◽

Peripheral Nerve Function ◽

Male Subjects

The possible ill-effects of cannabis on the peripheral nervous system were examined in 27 male subjects with respect to their motor and sensory nerve conduction. They were classified by their previous cannabis use into casual and heavy users. The nerve conduction studies were done after a baseline period of five days and then repeated after a three-week period during which the subjects could acquire and smoke standardized cannabis cigarettes. The casual users smoked a mean of 54·3 and the heavy users a mean of 109·5, cigarettes during the smoking period. No deterioration of peripheral nerve function could be demonstrated.

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Abnormal sensory nerve conduction in multifocal demyelinating neuropathy with persistent conduction block

Neurology ◽

10.1212/wnl.45.11.2024 ◽

1995 ◽

Vol 45 (11) ◽

pp. 2024-2028 ◽

Cited By ~ 9

Author(s):

J. Valls-Sole ◽

A. C. Martinez ◽

F. Graus ◽

A. Saiz ◽

J. Arpa ◽

...

Keyword(s):

Nerve Conduction ◽

Conduction Block ◽

Sensory Nerve ◽

Demyelinating Neuropathy

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Poster 236 Neoplastic Upper Trunk Brachial Plexus Lesion with Normal Sensory Nerve Conduction Studies: A Case Report

PM&R ◽

10.1016/j.pmrj.2015.06.274 ◽

2015 ◽

Vol 7 ◽

pp. S168-S169

Author(s):

Lisa Williams ◽

Joshua H. Levin

Keyword(s):

Case Report ◽

Brachial Plexus ◽

Nerve Conduction ◽

Sensory Nerve ◽

Nerve Conduction Studies ◽

Brachial Plexus Lesion ◽

Plexus Lesion

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Electromyography and Nerve Conduction Studies in Friedreich's Ataxia and Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS)

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100119614 ◽

1979 ◽

Vol 6 (2) ◽

pp. 185-189 ◽

Cited By ~ 29

Author(s):

J.P. Bouchard ◽

A. Barbeau ◽

R. Bouchard ◽

R.W. Bouchard

Keyword(s):

Nerve Conduction ◽

Autosomal Recessive ◽

Clinical Signs ◽

Sensory Nerve ◽

Friedreich’S Ataxia ◽

Friedreich's Ataxia ◽

Nerve Conduction Studies ◽

Spastic Ataxia ◽

Group I ◽

Electrophysiological Studies

SummaryTwenty four ataxie patients were investigated with electromyography and nerve conduction studies. They were divided in two groups according to the area they came from, the evolution of the disease, and the clinical signs. Group I patients from the Rimouski area displayed all the clinical and electrophysiological signs of Friedreich's ataxia. Group II comprised patients who presented with a new syndrome known as the autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS). Although the clinical evolution was better in the latter, there were more electromyographic signs of denervation and the motor conduction velocities were slower. Both groups showed identical and important abnormalities in sensory nerve conduction.The results of electrophysiological studies in spastic ataxia have not been reported to our knowledge. They underline the place of spastic ataxia as distinct f rom Friedreich's ataxia, spastic paraplegia, and the known familial neuropathies.

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