11/130. Lumbosacral plexopathy after dual kidney transplantation.A 58-year-old man underwent dual kidney transplantation. He was unable to move his right leg after surgery. This was caused by extensive lumbosacral plexopathy on the side of surgery. Lumbosacral plexopathy after kidney transplantation is uncommon, because the plexus has rich anastomotic blood supply, and ischemic injury is unlikely. However, isolated femoral neuropathy after renal transplantation has been reported, as the distal portion of this nerve is supplied by branches of internal iliac artery only and is more prone to ischemic injury during surgery. Dual-kidney transplantation involves a larger dissection, and the procedure takes 60 to 90 minutes longer than single-kidney transplantation. It involves more vascular reconstruction. This may predispose the lumbosacral plexus to ischemic injury. To the best of our knowledge, this is the first reported case of lumbosacral plexopathy after a dual kidney transplantation, and this may be seen more frequently because this procedure is becoming more common.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
12/130. Late-onset GM2 gangliosidosis presenting as burning dysesthesias.Two brothers with a painful neuropathy as a component of late-onset GM2 gangliosidosis of the Sandhoff type are presented. A dramatic response of the severe dysesthesias to amitriptyline and gabapentin is described. Symptomatic sensory neuropathy may be a component of late-onset GM2 gangliosidosis.- - - - - - - - - - ranking = 2keywords = neuropathy (Clic here for more details about this article) |
13/130. Superficial radial neuropathy following venepuncture.A 42-year-old female suffered excruciating pain and paraesthesia on venepuncture of the cephalic vein in her left wrist. The left superficial radial nerve was injured. A flexed wrist during venepuncture renders the superficial radial nerve immobile and vulnerable to being punctured by the needle. To reduce the risk of nerve injury during venepuncture, the phlebotomist should choose a large and visible vein and insert the needle at a 5-15 degrees angle with the skin. The wrist should be selected only if the veins in the antecubital area are deemed unsuitable. The feeling of an electric shock along the distribution of the nerve, or rupture of the vein during venepuncture, should alert the phlebotomist to the possibility of nerve injury and the procedure should be stopped immediately.- - - - - - - - - - ranking = 4keywords = neuropathy (Clic here for more details about this article) |
14/130. Meralgia paresthetica in differential diagnosis of low-back pain.OBJECTIVE: Meralgia paresthetica is a syndrome of pain or dysesthesia or both in the anterolateral thigh, caused by entrapment of the lateral femoral cutaneous nerve at the anterior superior iliac spine. The aim of this report is to emphasize that meralgia paresthetica can be confused with low-back pain. PATIENT: A 21-year-old man was admitted to hospital because of low-back and thigh pain. He had a history of low-back pain. physical examination and radiologic studies for low-back pain and radiculopathy showed no pathologic findings. It was suspected that the most likely cause was lateral femoral cutaneous neuropathy, caused by the wide military belt he continuously wore tightly around his waist. INTERVENTIONS: The nerve was blocked with 10 ml of bupivacaine 0.25%, which provided immediate pain relief. A nonsteroidal anti-inflammatory drug was administered orally. RESULTS: After 15 days of bed rest and 45 days without the belt, he was completely symptom-free. CONCLUSIONS: It is important to be rigorous in investigating the etiology of low-back pain. Meralgia paresthetica can mimic low-back pain because of the similarity of the symptoms. It can be treated by conservative or ablative therapeutic interventions; however, conservative methods should be considered primarily.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
15/130. Meralgia paresthetica: an unusual complication of cardiac catheterization via the femoral artery.Nerve complications following cardiac catheterization via the femoral route are rare. We report a case of meralgia paresthetica, a mononeuropathy affecting the lateral cutaneous nerve of the thigh following uncomplicated cardiac catheterization and percutaneous intervention via this route.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
16/130. Hydroquinone neuropathy following use of skin bleaching creams: case report.A 30-year old black woman presented with gradual onset of weakness of the legs associated with burning sensation in the feet for two months. She had been using two hydroquinone based skin bleaching creams (MGC by M. G. C. International, MEKAKO by Anglo Fabrics BOLTON Ltd) for about four years. Her BP was 80/40 mm Hg supine with un-recordable diastolic pressure on standing. She had decreased power (Grade 3/5), loss of deep tendon reflexes and impairment of deep sensation in the lower limbs. A complete blood count, urinalysis, serum electrolytes, serum creatinine and uric acid were all normal. Oral GTT, VDRL and brucella tests were negative. Chest and abdominal radiographs did not show any abnormalities. A diagnosis of peripheral neuropathy with autonomic neuropathy possibly due to hydroquinone toxicity was made and she was advised to stop using hydroquinone based skin bleaching creams. Four months later she was asymptomatic, her BP was 120/80 mmHg supine and standing, and neurological examination was normal. The case raises the question of whether hydroquinone based skin bleaching creams could be a cause of peripheral neuropathy and underscores the need for research on hydroquinone based skin bleaching creams and neuropathy particularly in black women involved in the sale and/or use of skin bleaching creams.- - - - - - - - - - ranking = 8.0000817942659keywords = neuropathy, deep (Clic here for more details about this article) |
17/130. Lhermitte sign and urinary retention: atypical presentation of oxaliplatin neurotoxicity in four patients.BACKGROUND: Regimens combining oxaliplatin with fluorouracil and folinic acid are standard therapeutic options for patients with metastatic colorectal carcinoma. Oxaliplatin has a good safety profile, although it is responsible for dose-limiting neurotoxicity typically consisting of two distinct clusters of symptoms. Cold-induced distal paresthesiae occur during or shortly after infusion in most patients and are usually transient and mild. A persistent sensory peripheral neuropathy may develop with prolonged treatment, eventually causing superficial and deep sensory loss, sensory ataxia and functional impairment. methods: The authors report four cases of atypical neurotoxicity induced by oxaliplatin in patients treated for metastatic colorectal carcinoma. Two patients were male and two were female, with an age range of 52-59 years. RESULTS: Three patients experienced Lhermitte sign and two experienced urinary retention. In all cases, the cumulative dose of oxaliplatin was higher than 1000 mg (range, 1248-2040 mg). brain and spinal magnetic resonance imaging was performed in two patients and was normal. Somatosensory evoked potentials were recorded in two patients and suggested cervical dorsal column dysfunction. Symptoms resolved a few weeks after discontinuation of oxaliplatin. CONCLUSIONS: Lhermitte sign may be induced via a neurotoxic effect on the ascending axons of these T-shaped neurons. An atonic bladder may be the result of damage to the sensory portion of the sacral reflex arc, either in the dorsal roots, as for example in diabetic neuropathy, or in the posterior columns, as in tabes dorsalis. Alternatively, it may result from a paralysis of the parasympathetic fibers that control the bladder musculature. It is unclear at present whether the micturition difficulties observed in patients in the current series are due to sensory neuropathy or to autonomic neuropathy, event if the former hypothesis seems more likely, as autonomic neuropathy has not been previously observed with oxaliplatin, and its association with cisplatin is exceedingly rare and controversial.- - - - - - - - - - ranking = 5.000040897133keywords = neuropathy, deep (Clic here for more details about this article) |
18/130. Dramatic recovery of paclitaxel-disabling neurosensory toxicity following treatment with venlafaxine.Venlafaxine is an antidepressant which acts through the inhibition of the reuptake of norepinephrine and serotonin. Venlafaxine is active against neuropathic and chronic pain. We report the case of a 69-year-old woman who presented a paclitaxel-induced neuropathy. She presented paresthesias, pin pricks in both hands with functional impairment. Venlafaxine hydrochloride was introduced at 37.5 mg twice daily. The patient noticed a dramatic recovery of her symptoms within 2 days, with both reduction of the paresthesias and functional improvement. This is the first report of efficacious use of venlafaxine for the treatment of paclitaxel cumulative neurosensory toxicity.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
19/130. Notalgia paresthetica with a significant increase in the number of intradermal nerves.Notalgia paresthetica is an isolated mononeuropathy involving the skin over or near the scapula. The cause remains unknown. We histologically observed a significant increase in the number of dermal nerves in a case of notalgia paresthetica. Immunohistochemical examination using a neural marker, S-100, positively stained the nerves. Interestingly, a biopsy from perilesional skin also showed an abnormal nerve proliferation.- - - - - - - - - - ranking = 1keywords = neuropathy (Clic here for more details about this article) |
20/130. thalidomide-induced neuropathy.BACKGROUND: thalidomide is effective for the treatment of some refractory dermatologic and oncologic diseases. Toxic neuropathy limits its use, as embryopathy can be avoided by contraceptive measures. OBJECTIVE: To describe the clinical, electrophysiologic, and pathologic features of thalidomide-induced peripheral neuropathy. methods: Clinical and electrophysiologic examinations were performed in seven patients with thalidomide-induced peripheral neuropathy. thalidomide was used for graft-vs-host disease, pyoderma gangrenosum, and discoid lupus with dosages ranging from 100 to 1,200 mg/day for 5 to 16 months (cumulative dosages of 24 to 384 g). RESULTS: All seven patients had clinical and electrophysiologic evidence of a sensory more than motor, axonal, length-dependent polyneuropathy that presented as painful paresthesias or numbness. sural nerve biopsies, done in three patients, showed evidence of wallerian degeneration and loss of myelinated fibers. The symptoms, signs, and electrophysiologic data correlated with total cumulative dose of thalidomide. CONCLUSIONS: thalidomide induces a dose-dependent sensorimotor length-dependent axonal neuropathy; it should be judiciously used with close neurologic monitoring.- - - - - - - - - - ranking = 9keywords = neuropathy (Clic here for more details about this article) |
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