Electrophysiological evaluation of peripheral neuropathy in chronic kidney disease patients: A study from tertiary care centre, Maharashtra

2020 ◽  
Vol 8 (2) ◽  
pp. 29-37
Author(s):  
Gajanan Gondhali ◽  
J K Deshmukh ◽  
Ashish Kundalwal ◽  
ANANT TAKALKAR
Keyword(s):  
Peripheral Neuropathy ◽  
Tibial Nerve ◽  
Motor Pattern ◽  
Tertiary Care ◽  
Motor Neuropathy ◽  
Posterior Tibial Nerve ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Posterior Tibial ◽  
Sensory Motor

ntroduction: CKD has turned a major cause of morbidity and mortality. The prevalence of peripheral neuropathy is directly proportional to duration and severity of CKD. Peripheral neuropathy becomes evident after the patient reaches stage 4 CKD, but electrophysiological evidences occurs earlier. NCS is an important means of evaluating the functional integrity of peripheral nerves and has implications regarding clinical course and prognosis. Objectives: To study electrophysiological findings of peripheral neuropathy in CKD patients Methodology: The present study was a cross sectional; descriptive study was conducted in October 2016 to October 2018. Data analysed by using SPSS 23.0 version. Clinical and neurological examinations were done and blood investigations were performed following which NCS was done. Results: Out of 90 subjects, majority were from 45-54 years age group (26). 70% were male and 30% were females. Total 10 (11.11%) patients showed pure sensory type of PN. Total 47 (52.22%) patients showed sensory-motor type of PN. sensory-motor type of PN was the predominant type (52.22%) found in study followed by pure sensory type of PN (11.11%). Pure axonal sensory motor pattern of PN found in 15 (25%) patients in preHD group, 11 (36.66%) patients in HD group. The difference between the pre-HD and HD groups were statistically significant for the median nerve amplitude, common peroneal nerve CV, posterior tibial nerve CV, posterior tibial nerve distal latency and sural nerve distal latency (p < 0.05). Conclusion:Peripheral neuropathy is very common in CKD, more common in dialysis patients as compared to predialysis patients. It’s frequency and severity increase as the duration of disease and stage of CKD increases. Sensory motor type of neuropathy is more common than pure sensory type of neuropathy.Pure axonal sensory motor and mixed (axonal + demyelinating) sensory motor neuropathy are common patterns of PN in CKD.

scholarly journals Comparison of Cross Sectional Area of Posterior Tibial Nerve in Diabetic Peripheral Neuropathy Patients with That of Healthy Controls Using High Resolution Ultrasonography - A Cross Sectional Comparative Descriptive Study from Bangalore

2021 ◽  
Vol 8 (20) ◽  
pp. 1466-1472
Author(s):  
Chandrashekar H.M. ◽  
Mohan S ◽  
Srinivas M.R
Keyword(s):  
Peripheral Neuropathy ◽  
High Resolution ◽  
Tibial Nerve ◽  
Diabetic Patients ◽  
Posterior Tibial Nerve ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Posterior Tibial ◽  
High Resolution Ultrasonography

BACKGROUND Patients with diabetic peripheral neuropathy (DPN) suffer from numbness, burning feet, lightning pain, and pins-and-needles sensations. Recently, High resolution ultrasonography is commonly used for evaluation of peripheral nerve diseases because of its easy availability, time saving and non-invasiveness of the procedure. This study intended to compare the cross sectional area (CSA) of posterior tibial nerve (PTN) in type 2 diabetic patients with peripheral neuropathy with that of non-diabetic healthy adults using high resolution ultrasonography (HRU) and study the role of increase in HbA1c level and severity of DPN comparing with CSA of PTN. METHODS A cross sectional comparative descriptive study was conducted from November 2018 to May 2020 with 50 type 2 diabetic patients and 50 healthy adults. 50 type 2 diabetic patients, clinically diagnosed with DPN were analysed and using the Toronto Clinical Neuropathy Score (TCNS) System, the severity of neuropathy was determined. HbA1c level and other demographic data were collected. 50 healthy adults were taken as controls. The CSA of posterior tibial nerve was measured 3 cm proximal to the medial malleolus in both lower limbs using HRU. RESULTS The mean CSA of posterior tibial nerve in healthy subjects was 6.0 + / - 0.142 mm2 , and in diabetic patients with peripheral neuropathy was 11.77 + / - 0.291 mm2 . Upon comparing the mean CSA of posterior tibial nerve of diabetic subjects with peripheral neuropathy and control subjects were statistically significant (P < 0.001) in unpaired ‘t’ test. In our study, CSA of the posterior tibial nerve correlated significantly with TCNS and HbA1c levels, at P < 0.001. CONCLUSIONS This study showed that there is a significant difference between the cross sectional areas of posterior tibial nerve in diabetic subjects with peripheral neuropathy and healthy adult subjects. HRU can detect cross sectional area changes in the posterior tibial nerve early. Thus, ultrasonography can be used as a good screening tool in these patients. KEYWORDS Diabetic Peripheral Neuropathy, Posterior Tibial Nerve, High Resolution Ultrasonography

scholarly journals Leprosy Mononeuritis Multiplex: ulnar, peroneal and tibial decompression surgery

2020 ◽  
Vol 31 (4) ◽  
pp. 386-388
Author(s):  
Lívio Pereira de Macêdo ◽  
João Batista Monte Freire Filho ◽  
Arlindo Ugulino Netto ◽  
Kauê Franke ◽  
Nivaldo S. Almeida ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Tibial Nerve ◽  
Mycobacterium Leprae ◽  
Decompression Surgery ◽  
Posterior Tibial Nerve ◽  
Fibular Head ◽  
Mononeuritis Multiplex ◽  
Posterior Tibial ◽  
Left Posterior ◽  
Nerve Release

Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. In this case, we report a case of a patient that was submitted to left ulnar nerve decompression at elbow, left common peroneal release at the fibular head and left posterior tibial nerve release in order to relief neurophatic pain and avoid deformities.

scholarly journals Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Tertiary Care ◽  
Case Series ◽  
Brazilian Amazon ◽  
Outcome Data ◽  
Malaria Episode ◽  
Tertiary Care Centre ◽  
Cross Sectional

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.

scholarly journals Percutaneous versus Transcutaneous Electrical Stimulation of the Posterior Tibial Nerve in Idiopathic Overactive Bladder Syndrome with Urinary Incontinence in Adults: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 879
Author(s):  
Aida Agost-González ◽  
Isabel Escobio-Prieto ◽  
Azahara M. Pareja-Leal ◽  
María Jesús Casuso-Holgado ◽  
María Blanco-Diaz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Incontinence ◽  
Electrical Stimulation ◽  
Overactive Bladder ◽  
Tibial Nerve ◽  
Scientific Evidence ◽  
Transcutaneous Electrical Stimulation ◽  
Posterior Tibial Nerve ◽  
Posterior Tibial

Background: Percutaneous electrical stimulation and transcutaneous electrical stimulation (PTNS and TTNS) of the posterior tibial nerve are internationally recognized treatment methods that offer advantages in terms of treating patients with overactive bladder (OAB) who present with urinary incontinence (UI). This article aims to analyze the scientific evidence for the treatment of OAB with UI in adults using PTNS versus TTNS procedures in the posterior tibial nerve. Methods: A systematic review was conducted, between February and May 2021 in the Web of Science and Scopus databases, in accordance with the PRISMA recommendations. Results: The research identified 259 studies, 130 of which were selected and analyzed, with only 19 used according to the inclusion requirements established. The greatest effectiveness, in reducing UI and in other parameters of daily voiding and quality of life, was obtained by combining both techniques with other treatments, pharmacological treatments, or exercise. Conclusions: TTNS has advantages over PTNS as it is more comfortable for the patient even though there is equality of both therapies in the outcome variables. More research studies are necessary in order to obtain clear scientific evidence.

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