scholarly journals Botulinum Toxin Treatment for Painful Diabetic Neuropathy A Review

2019 ◽  
pp. 01-04
Author(s):  
Bahman Jabbari ◽  
Yasaman Safarpour
Keyword(s):  
Nervous System ◽  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Late Onset ◽  
Lower Limbs ◽  
Type I ◽  
Type Ii ◽  
Painful Diabetic Neuropathy ◽  
Onset Diabetes ◽  
Botulinum Toxin Treatment

Diabetic neuropathy (DN) is one of the most common peripheral nervous system disorders. It affects 16% of individuals with type I (young onset) diabetes and 25-26% of individuals with type II (late onset) diabetes [1]. Pain and numbness of the feet and, in advanced cases, weakness in the feet or hands are the usual symptoms. These symptoms are typically more prominent in the lower limbs. The skin in the affected areas is sensitive to touch (hyperesthesia); sometimes touch evokes pain (allodynia). The pain of diabetic neuropathy may develop spontaneously or may be provoked by touch or motion. Pain often interferes with patient’s rest and sleep and has typical characteristics of a neuropathic pain i.e having a sharp and burning quality. Dorsum of the foot and toes are most commonly affected in diabetic neuropathy. On examination, the patients demonstrate decreased sensations (heat, cold, touch, position) in the affected limb. Diabetic neuropathy (DN) is usually bilateral and presents in form of a polyneuropathy.

scholarly journals Demographic Characteristics of Diabetic Neuropathy Patients Attended at a Tertiary Care Hospital in Dhaka City

2019 ◽  
Vol 31 (1) ◽  
pp. 27-30
Author(s):  
Mohammad Mashudur Rahman ◽  
Abu Nasir Rizvi ◽  
Mohammad Nazim Uddin ◽  
Rashida Akter Khanam ◽  
Muhammad Abdul Momen Khan ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Demographic Characteristics ◽  
Outpatient Department ◽  
Diabetic Patients ◽  
Type I ◽  
Care Hospital ◽  
Type Ii ◽  
Study Population ◽  
The Mean

Introduction: Diabetic neuropathy is one of the early complications of diabetes mellitus patients which is very difficult to face in the daily living activities. The purpose of the present study was to see the demographic characteristics of diabetic neuropathy patients. Metarials & Methods: This descriptive type of cross-sectional study was conducted in the Department of Neurology including Neuropathy Clinic and in collaboration with department of Endocrinology at Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2012 to December 2013 for a period of two (2) years. Adult diabetic patients presented with neuropathic pain with symmetrical involvement of distal limbs from indoor and outpatient department of Neurology including Neuropathy clinic as well as indoor and outpatient department of Endocrinology, BSMMU were enrolled in the study population. Data was collected by face to face interview. Information was collected by taking medical history and clinical examinations and subsequent laboratory investigations. Results: A total number of 102 cases were recruited for this study who were clinically diagnosed as painful diabetic polyneuropathy. Female was predominant than male 55(53.9%) cases and 47(46.1%) cases respectively. The male and female ratio was 1:1.2. Majority were in the age group of more than 55 years which was 55(53.9%) cases. The mean age with SD of the study population was 52.79±9.42 years. Among 102 patients type II DM was predominate than type I patients which were 95(92.2%) cases and 8(7.8%) cases respectively. The mean duration of DM with SD was 6.51±3.6 years. However the mean duration of neuropathic pain was 1.68±1.155 years. Conclusion: In conclusion majority of the diabetic neuropathy patients are female suffering from type II DM in the middle age. Medicine Today 2019 Vol.31(1): 27-30

scholarly journals Pathogenesis of Painful Diabetic Neuropathy

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Amir Aslam ◽  
Jaipaul Singh ◽  
Satyan Rajbhandari
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Diabetic Neuropathy ◽  
Peripheral Nerves ◽  
Daily Life ◽  
Painful Diabetic Neuropathy ◽  
Common Cause ◽  
The Central Nervous System

The prevalence of diabetes is rising globally and, as a result, its associated complications are also rising. Painful diabetic neuropathy (PDN) is a well-known complication of diabetes and the most common cause of all neuropathic pain. About one-third of all diabetes patients suffer from PDN. It has a huge effect on a person’s daily life, both physically and mentally. Despite huge advances in diabetes and neurology, the exact mechanism of pain causation in PDN is still not clear. The origin of pain could be in the peripheral nerves of the central nervous system. In this review, we discuss various possible mechanisms of the pathogenesis of pain in PDN. We discuss the role of hyperglycaemia in altering the physiology of peripheral nerves. We also describe central mechanisms of pain.

scholarly journals Differential Effects of Three CanonicalToxoplasmaStrains on Gene Expression in Human Neuroepithelial Cells

2010 ◽  
Vol 79 (3) ◽  
pp. 1363-1373 ◽  
Author(s):  
Jianchun Xiao ◽  
Lorraine Jones-Brando ◽  
C. Conover Talbot ◽  
Robert H. Yolken
Keyword(s):  
Gene Expression ◽  
Central Nervous System ◽  
Nervous System ◽  
Nucleotide Metabolism ◽  
Neural Cells ◽  
Type I ◽  
Type Ii ◽  
Type Iii ◽  
Neuroepithelial Cells ◽  
The Central Nervous System

ABSTRACTStrain type is one of the key factors suspected to play a role in determining the outcome ofToxoplasmainfection. In this study, we examined the transcriptional profile of human neuroepithelioma cells in response to representative strains ofToxoplasmaby using microarray analysis to characterize the strain-specific host cell response. The study of neural cells is of interest in light of the ability ofToxoplasmato infect the brain and to establish persistent infection within the central nervous system. We found that the extents of the expression changes varied considerably among the three strains. Neuroepithelial cells infected withToxoplasmatype I exhibited the highest level of differential gene expression, whereas type II-infected cells had a substantially smaller number of genes which were differentially expressed. Cells infected with type III exhibited intermediate effects on gene expression. The three strains also differed in the individual genes and gene pathways which were altered following cellular infection. For example, gene ontology (GO) analysis indicated that type I infection largely affects genes related to the central nervous system, while type III infection largely alters genes which affect nucleotide metabolism; type II infection does not alter the expression of a clearly defined set of genes. Moreover, Ingenuity Pathways Analysis (IPA) suggests that the three lineages differ in the ability to manipulate their host; e.g., they employ different strategies to avoid, deflect, or subvert host defense mechanisms. These observed differences may explain some of the variation in the neurobiological effects of different strains ofToxoplasmaon infected individuals.

scholarly journals Peripheral Nervous System Involvement in Late-Onset Cobalamin C Disease?

2020 ◽  
Vol 11 ◽  
Author(s):  
Xujun Chu ◽  
Lingchao Meng ◽  
Wei Zhang ◽  
Jinjun Luo ◽  
Zhaoxia Wang ◽  
...  
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Methylenetetrahydrofolate Reductase ◽  
Late Onset ◽  
Hot Spot ◽  
Axonal Neuropathy ◽  
Methylmalonic Aciduria ◽  
Lower Limbs ◽  
Compound Heterozygous ◽  
Limb Weakness

Background: Cobalamin C (cblC) has a fundamental role in both central and peripheral nervous system function at any age. Neurologic manifestations may be the earliest and often the only manifestation of hereditary or acquired cblC defect. Peripheral neuropathy remains a classical but underdiagnosed complication of cblC defect, especially in late-onset cblC disease caused by mutations in the methylmalonic aciduria type C and homocysteinemia (MMACHC) gene. So the clinical, electrophysiological, and pathological characteristics of late-onset cblC disease are not well-known.Methods: A retrospective study of patients with late-onset cblC disease was conducted at our hospital on a 3-year period. The neuropathy was confirmed by the nerve conduction study. Sural biopsies were performed in 2 patients.Results: Eight patients were identified, with a mean onset age of 16.25 ± 6.07 years. All patients had methylmalonic aciduria, homocysteinemia, compound heterozygous MMACHC gene mutations were detected in all patients, and 7/8 patients with c.482G>A mutation. One patient concomitant with homozygote c.665C>T mutation in 5,10-methylenetetrahydrofolate reductase (MTHFR) gene. All patients showed limb weakness and cognitive impairment. Five patients had possible sensorimotor axonal polyneuropathy predominantly in the distal lower limbs. Sural biopsies showed loss of myelinated and unmyelinated fibers. Electro microscopy revealed crystalline-like inclusions bodies in Schwann cells and axonal degeneration.Conclusion: Late-onset cblC disease had possible heterogeneous group of distal axonal neuropathy. c.482G>A mutation is a hot spot mutation in late-onset cblC disease.

scholarly journals Sympathetic Blocks Provided Sustained Pain Relief in a Patient with Refractory Painful Diabetic Neuropathy

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Jianguo Cheng ◽  
Anuj Daftari ◽  
Lan Zhou
Keyword(s):  
Nervous System ◽  
Pain Relief ◽  
Sympathetic Nervous System ◽  
Diabetic Neuropathy ◽  
Critical Role ◽  
Sensory Neuropathy ◽  
Painful Diabetic Neuropathy ◽  
Nerve Blocks ◽  
Sympathetic Nervous ◽  
Sympathetic Blocks

The sympathetic nervous system has been implicated in pain associated with painful diabetic neuropathy. However, therapeutic intervention targeted at the sympathetic nervous system has not been established. We thus tested the hypothesis that sympathetic nerve blocks significantly reduce pain in a patient with painful diabetic neuropathy who has failed multiple pharmacological treatments. The diagnosis of small fiber sensory neuropathy was based on clinical presentations and confirmed by skin biopsies. A series of 9 lumbar sympathetic blocks over a 26-month period provided sustained pain relief in his legs. Additional thoracic paravertebral blocks further provided control of the pain in the trunk which can occasionally be seen in severe diabetic neuropathy cases, consequent to extensive involvement of the intercostal nerves. These blocks provided sustained and significant pain relief and improvement of quality of life over a period of more than two years. We thus provided the first clinical evidence supporting the notion that sympathetic nervous system plays a critical role in painful diabetic neuropathy and sympathetic blocks can be an effective management modality of painful diabetic neuropathy. We concluded that the sympathetic nervous system is a valuable therapeutic target of pharmacological and interventional modalities of treatments in painful diabetic neuropathy patients.

Review of the Toxicology of Mineral Spirits

2008 ◽  
Vol 27 (1) ◽  
pp. 97-165 ◽  
Author(s):  
Marie A. Amoruso ◽  
John F. Gamble ◽  
Richard H. McKee ◽  
Arlean M. Rohde ◽  
Andrew Jaques
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Toxicity ◽  
Systemic Effects ◽  
Type I ◽  
Type Ii ◽  
Class A ◽  
Boiling Range ◽  
Class C ◽  
Mineral Spirits

This review of the toxicology of mineral spirits covers studies of the major classes of mineral spirits and several toxicologically important mineral spirit constituents. This review cites data from numerous previously unpublished animal toxicology studies conducted on mineral spirits during the past 30 years, expanding the existing database on the toxicology of this group of hydrocarbon solvents. The data can be used to better evaluate the potential effects associated with exposure to these materials, including health and environmental reviews such as the U.S. Environmental Protection Agency High Production Volume (HPV) chemical program and the Organization for Economic Cooperation and Development (OECD) HPV Screening Information Data Set (SIDS) program. The majority of animal toxicology studies in the available literature were conducted on mineral spirits categorized as ASTM D235 Type I Class A (149°C to 213°C boiling range; 8% to 22% aromatics) and demonstrate that Type I Class A mineral spirits have a low order of acute toxicity and do not produce significant systemic effects. Some additional studies conducted with ASTM D235 Type II Class C mineral spirits (177°C to 213°C boiling range; <2% aromatics) suggest that Type II Class C mineral spirits have similar toxicity to Type I Class A mineral spirits, though there is some evidence that Type II, Class C mineral spirits have a lesser degree of central nervous system (CNS) effects than the higher aromatic containing Type I Class A materials. In addition, toxicity data on selected chemical constituents of mineral spirits (e.g., n-nonane, n-decane, n-undecane) indicate that these chemicals have similar toxicological properties to mineral spirits. Overall, the data showed that mineral spirits have a low order of acute toxicity and do not appear to produce toxicologically relevant systemic effects. Ongoing studies are evaluating the concerns associated with chronic low-level exposure and central nervous system effects.

Controlled-release oxycodone relieves neuropathic pain: a randomized controlled trial in painful diabetic neuropathy

Pain ◽  
2003 ◽  
Vol 105 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Peter C.N. Watson ◽  
Dwight Moulin ◽  
Judith Watt-Watson ◽  
Allan Gordon ◽  
John Eisenhoffer
Keyword(s):  
Randomized Controlled Trial ◽  
Neuropathic Pain ◽  
Controlled Release ◽  
Diabetic Neuropathy ◽  
Controlled Trial ◽  
Painful Diabetic Neuropathy ◽  
Randomized Controlled

scholarly journals ASSOCIATION OF SERUM HOMOCYSTEINE IN DIABETIC NEUROPATHY

2018 ◽  
Vol 11 ◽  
Author(s):  
Rujaswini T ◽  
Ranadheer Chowdary P ◽  
Vijey Aanandhi M ◽  
Shanmugasundaram P
Keyword(s):  
Diabetic Neuropathy ◽  
Blood Sugar ◽  
Elevated Serum ◽  
Serum Levels ◽  
Blood Parameters ◽  
P Value ◽  
Diabetic Patients ◽  
Type I ◽  
Type Ii ◽  
Serum Homocysteine

Aims and Objectives: The main aim of the study was to find out the association of serum homocysteine (HCY) in diabetic neuropathy patients. Methods: All the patients who were diagnosed with Type II diabetes mellitus will be included. Their serum levels of fasting blood sugar, postprandial blood sugar, glycated hemoglobin, and associated blood parameters will be assessed. Diabetic neuropathy will be confirmed using nerve conduction testing, electromyography, and quantitative sensory testing with clinically correlated. The serum HCY levels will be measured and correlated with other blood parameters. Results: Of 1000 patients, 46 were Type I diabetic and 954 were Type II. The prevalence of neuropathy in diabetic patients was 156. Mean serum HCY without diabetic neuropathy was 6.8+2.9 and serum HCY with diabetic neuropathy was 21.6+0.29 and p value was found to be 0.0017. The correlation between serum HCY and diabetic neuropathy was found to be 14.5 with p=0.001. Conclusion: There has been a significant increase of HCY in diabetic patients. It can be clearly seen that elevated serum HCY level has led to some of the complications of diabetic neuropathy.

scholarly journals Atypical antipsychotics and the negative symptoms of schizophrenia

1998 ◽  
Vol 4 (1) ◽  
pp. 53-61 ◽  
Author(s):  
David J. King
Keyword(s):  
Nervous System ◽  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Genetic Factors ◽  
Cortical Atrophy ◽  
Positive Symptoms ◽  
Type I ◽  
Type Ii ◽  
Positive And Negative Symptoms

The concept of positive and negative symptoms in schizophrenia can be traced back to Hughlings Jackson (1889) who taught that disease does not create, it sets free, and accordingly positive symptoms could be seen as ‘release’ phenomena resulting from ‘dissolution’ of the highest cerebral centres of the nervous system. Crow (1980) revived the dichotomy and proposed a Type I syndrome, characterised by positive symptoms, and a Type II syndrome, characterised by negative symptoms. He thought the latter was due to cortical atrophy and responded poorly to antipsychotic medication. In their review of the distinction, Walker & Lewine (1988) found a stronger relationship between premorbid dysfunction and negative symptoms than with positive symptoms. They also found there was a stronger influence of genetic factors on negative symptoms than positive symptoms.

scholarly journals Bergenin Reduces Experimental Painful Diabetic Neuropathy by Restoring Redox and Immune Homeostasis in the Nervous System

2020 ◽  
Vol 21 (14) ◽  
pp. 4850 ◽  
Author(s):  
Cristiane F. Villarreal ◽  
Dourivaldo S. Santos ◽  
Pedro S. S. Lauria ◽  
Kelly B. Gama ◽  
Renan F. Espírito-Santo ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Nervous System ◽  
Diabetic Neuropathy ◽  
Therapeutic Potential ◽  
Antioxidant Properties ◽  
Immune Homeostasis ◽  
No Production ◽  
Painful Diabetic Neuropathy ◽  
Antioxidant Genes ◽  
Anti Inflammatory

Diabetic neuropathy is a frequent complication of diabetes. Symptoms include neuropathic pain and sensory alterations—no effective treatments are currently available. This work characterized the therapeutic effect of bergenin in a mouse (C57/BL6) model of streptozotocin-induced painful diabetic neuropathy. Nociceptive thresholds were assessed by the von Frey test. Cytokines, antioxidant genes, and oxidative stress markers were measured in nervous tissues by ELISA, RT-qPCR, and biochemical analyses. Single (3.125–25 mg/kg) or multiple (25 mg/kg; twice a day for 14 days) treatments with bergenin reduced the behavioral signs of diabetic neuropathy in mice. Bergenin reduced both nitric oxide (NO) production in vitro and malondialdehyde (MDA)/nitrite amounts in vivo. These antioxidant properties can be attributed to the modulation of gene expression by the downregulation of inducible nitric oxide synthase (iNOS) and upregulation of glutathione peroxidase and Nrf2 in the nervous system. Bergenin also modulated the pro- and anti-inflammatory cytokines production in neuropathic mice. The long-lasting antinociceptive effect induced by bergenin in neuropathic mice, was associated with a shift of the cytokine balance toward anti-inflammatory predominance and upregulation of antioxidant pathways, favoring the reestablishment of redox and immune homeostasis in the nervous system. These results point to the therapeutic potential of bergenin in the treatment of painful diabetic neuropathy.

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