多环芳烃对接触人群外周神经传导速度的影响

为探讨多环芳烃对焦炉工外周神经功能的影响,选取焦炉工炉顶、炉侧、炉底工种各15名作为研究对象。收集工人的班后尿,用高效液相色谱法检测尿中1-羟基芘的水平,同时测定研究对象的双侧正中神经和尺神经的感觉和运动神经(排除受伤神经)传导速度(SCV和MCV)、远端潜伏期(SL和ML)。结果显示焦炉工人尿中1-羟基芘水平显著高于对照组,各接触组感觉和运动神经传导速度、远端潜伏期与对照组比较差异无统计学意义,提示多环芳烃未引起焦炉作业工人外周神经传导速度的改变。 更多还原     

糖尿病患者：呵护始于足下

许多糖尿病患者随着病情发展,会发生足部血液循环障碍,足部缺氧,甚至会起疱、溃疡和疼痛而导致伤口难以愈合。另外,糖尿病神经损害（又称外周神经病变）可以引起足部神经麻痹,造成足部感觉迟钝,这种情况下,如果糖尿病患者不加注意或没有及时处理溃疡,则可能发展为程度更重的感染,甚至最终导致截肢。糖尿病外周神经病变也可以引起足部锐痛,     

糖尿病神经病变的防治

糖尿病引起的神经病变是糖尿病最常见的慢性并发症之一,是糖尿病致死和致残的主要原因.早期诊断、早期治疗。可防止或延缓病变的发生和发展。病变晚期、预后不佳。常见的糖尿病神经病变有哪些？糖尿病引起的神经病变主要以糖尿病周围神经病变和植物神经病变最常见。糖尿病的周围神经病变中感觉神经病变化运动神经病变多见、运动神经最指挥人体运动的、如人体起卧跑跳等日常活动,出现病变时,会发生肌肉无力、萎缩、不能随意活动;人体感觉神经主要是感知冰冷火热。硬软／劳痛。感觉神经出了问题,人体感觉就会出现紊乱。植物神经。又称自…     

酒精中毒性精神障碍病人多发性周围神经病的临床和电生理观察

对30例酒精中毒性精神障碍多发性周围神经病的临床和电生理进行检测。结果显示：其临床症状是四肢疼痛、麻木、感觉减退等，肌电图（EMG）示均有神经源性损害。运动神经（MCV）和感觉神经传导速度值（SCV0明显低于对照组（P＜0.001）。提示本病外周神经损害严重，电生理检查对临床诊断和治疗有所帮助。     

有机磷中毒后对神经电图的慢性影响

对21例有机磷作业工人周围神经损害的临床表现与神经电图进行分析，发现长期接触有机磷致神经轴索损害为主，运动神经与感觉神经传导速度观察组与对照组比较，差异有显著性（P＜0．01）。神经传导速度检测，不仅可以提高有机磷中毒神经电生理检测异常率，还可以对神经损害程度、范围，提供可靠的诊断依据。     

糖尿病性周围神经病变的药物治疗进展

糖尿病周围神经病变是糖尿病的常见并发症之一,可累及感觉神经、运动神经和植物神经,包括局限性和弥漫性两组神经病变。其发病机制尚未完全阐明,胰岛素缺乏和高血糖是始动因素,神经缺血、多元醇通路活性增高、神经营养因子减少、自身免疫等共同参与。治疗应针对发病机...     

糖尿病患者手足麻木的中医治疗

<正>在门诊经常会遇到糖尿病患者因为手足麻木疼痛前来就诊,出现这种情况,很可能是患了糖尿病并发症——糖尿病周围神经病变。周围神经病变到底是怎么回事呢?糖尿病周围神经病变,是糖尿病所致神经病变中最常见的一种,发病率为30%～90%。神经病变可累及感觉神经、运动神经,产生疼痛、麻木、运动障碍及各种感觉异常,严重影响     

痛性糖尿病神经病变联合用药疗效佳

痛性糖尿病神经病变是糖尿病神经病变的类型之一．主要表现为肢体远端．特别是下肢皮肤的烧灼样疼痛,并常常伴有感觉过敏、肢体麻木及植物神经功能障碍等症状．同时呈现血糖升高．糖化血红蛋白增高和糖耐量异常等糖尿病改变,肌电图多显示运动神经和感觉神经传导速度减慢。     

二硫化碳作业工人神经电生理检测结果分析

目的 检测接触二硫化碳(CS2)工人神经肌电图,为寻找职业性体检神经肌肉电生理的筛查指标提供依据.方法 检测接触CS2工人正中神经、尺神经、腓总神经、胫后神经运动神经的潜伏期和波幅,对主诉肢体麻木明显的151人增加了正中神经、尺神经觉、腓肠神经感觉神经的潜伏期和传导 速度检测.将检测结果与GBZ 76-2002《职业性急性化学物中毒性神经系统疾病诊断标准》附录B中表B.2运动神经传导速度、表B.3感觉神经传导速度中神经指标参考值进行对照.结果 596人(60.3％,596/989)主诉头昏、头痛、失眠、多梦、易怒、记忆力明显减退、肢体麻木、肢体抽搐、肢体酸痛等症状.989人中共94例有至少1项神经传导速度检测指标异常,94例神经传导速度异常者中共检出神经传导速度异常神经148条;64条正中神经传导速度异常,占全部神经传导速度异常神经的43.24％(64/148),36条(24.32％,36/148)尺神经传导速度异常,38条(25.68％,38/148)腓总神经传导速度异常,9条(6.08％,9/148)胫后神经和1条(0.68％,1/148)腓肠神经传导速度异常.与GBZ 76-2002标准比较,正中神经、胫后神经、腓总神经运动神经末端潜伏期降低,尺神经运动神经末端潜伏期升高,差异均有统计学意义(P＜0.01).与GBZ 76-2002标准比较,CS2作业工人正中神经、尺神经感觉神经传导速度降低,差异有统计学意义(P＜0.01).与GBZ 76-2002标准比较,CS2作业工人正中神经、尺神经、腓肠神经感觉神经末端潜伏期延长,差异有统计学意义(P＜0.01).结论 感觉神经可以作为接触CS2作业工人职业性体检中神经肌电图检测的必检神经,感觉神经潜伏期、传导速度可以作为职业性体检检测指标.     

超声诊断外周神经鞘类肿瘤的临床价值观察

目的:整理我院外周神经鞘类肿瘤患者资料,探讨分析超声诊断外周神经鞘类肿瘤的临床价值。方法:选取2015年3月-2017年1月来我院进行医治的外周神经鞘瘤患者63例为观察组,选同时期健康人63例做比较,为对照组。后就超声对外周神经鞘类肿瘤患者的诊断进行观察。结果:63例外周神经鞘瘤患者中,51例为患者为神经鞘瘤,12例患者为良性纤维瘤,通过手术和病理结果发现有5例患者误诊,诊断率为92.1%。结论:超声诊断外周神经鞘类肿瘤准确率较高,安全快速定位准确,能为医生手术提供良好的影像学依据,在术前能够为医生提供准确的手术范围及手术方式的制定,应在临床上广泛推广应用。     

Effects of lymphoma on the peripheral nervous system.

Peripheral nervous system abnormalities occur in 5% of patients with lymphoma and have a wide differential diagnosis. Herpes zoster is the commonest cause. Vinca alkaloids are the only drugs used in lymphoma which commonly cause neuropathy. Compression or infiltration of nerve roots by lymphoma is a rare presenting feature but becomes more common with advanced disease. Radiation plexopathy does not usually develop until at least 6 months after irradiation and can be difficult to distinguish from neoplastic infiltration. Either multifocal infiltration of nerves or lymphoma-associated vasculitis may present as a peripheral neuropathy. The incidence of Guillain-Barré (GBS) syndrome, and possibly chronic idiopathic demyelinating polyradiculoneuropathy, appears to be increased in association with lymphoma, especially Hodgkin's disease. Subacute sensory neuronopathy and subacute lower motor neuronopathy have both been reported as paraneoplastic syndromes associated with Hodgkin's disease. Treatment of the underlying lymphoma is only rarely followed by recovery of the associated neuropathy.     

A clinical neurological,neurophysiological, and neuropsychological study of sheep farmers and dippers exposed to organophosphate pesticides

Objectives: To classify clinical diseases of the subjects with abnormal indices of peripheral neuropathy identified in field studies of sheep farmers and dippers exposed to organophosphate pesticides. To explore what neuropsychological profiles, if any, may be associated with neurophysiological damage in these subjects. Methods: A case-control study (79 subjects) nested within the cross sectional study (685 subjects) of sheep farmers from the field study. Three groups with no, possible, and probable or definite neuropathy according to field studies were recruited. Investigations comprised symptoms of neuropathy, neurologial signs, motor and sensory nerve conduction, electromyography, quantitative sensory testing, and neuropsychological tests. Results: The incidence of clinical neuropathy increased from 7% in the no neuropathy group to 52% in the probable or definite neuropathy group based on nerve conduction measurements or presence of neurological signs. Sensory abnormalities were found more often than motor deficits. Small diameter nerve fibres were also affected more than large fibres. Conclusions: The neuropathy is predominantly sensory and is characteristic of distal, chronic neuropathy with no acute features. Small fibre populations are affected more than large fibre populations. Increasing severity of neuropathy was associated with anxiety and depression as measured in the neuropsychological tests.     

Association between chronic exposure to arsenic and slow nerve conduction velocity among adolescents in Taiwan

The association between chronic exposure to arsenic and peripheral neuropathy has been controversial in previous studies, which may be due to the influence of factors, such as age, gender, chronic diseases, occupational injuries, and arsenic exposure. To clarify the question of this association, a cross-sectional study was designed. In total, 130 junior high school students aged 12-14 years were included and examined for the motor and sensory nerve conduction velocity of peripheral nerves in their right-upper and lower limbs. Concentrations of arsenic in well-water and history of drinking well-water were retrieved from a baseline database created in 1991. After adjustment for gender and height, a significant odds ratio of 2.9 (95% confidence interval [CI] 1.1-7.5) was observed for the development of slow nerve conduction velocity of the sural sensory action potential (SAP) among the study subjects with a cumulative arsenic dosage of>100.0 mg. In addition, a borderline statistical significance with odds ratio of 7.8 (95% CI 1.001-69.5) for the development of slow nerve conduction velocity of sural SAP was also observed among the study subjects who drank well-water containing arsenic concentrations of >50.0 microg/L and with a cumulative arsenic dosage of >100.0 mg. The study found that chronic exposure to arsenic might induce peripheral neuropathy. It also found that the slowing of the nerve conduction velocity of sural SAP might be an early marker of chronic arsenic neuropathy.     

Mononeuritis multiplex secondary to Lyme neuroborreliosis

Lyme neuroborreliosis (LNB) typically presents as a painful radiculitis or a cranial mononeuropathy with lymphocytic meningitis (Bannwarth’s syndrome). Isolated peripheral mononeuropathy or multiple mononeuropathy is less frequently recognised. A 58-year-old female with a background of IgA nephropathy and chronic kidney disease presented with a painful left ulnar neuropathy followed within 3 months by superficial radial neuropathy. Initial serum and cerebrospinal fluid (CSF) analysis were unremarkable; nerve conduction study was in keeping with a mononeuritis multiplex. A superficial radial nerve biopsy demonstrated inflammation with axonal injury consistent with a pathologically possible vasculitis. Borrelia antibodies were identified using enzyme-linked immunosorbent assay and immunoblot in serum consistent with active recent Lyme borreliosis. A 6-week course of doxycycline was initiated with gradual resolution of pain and improved power. A repeat nerve conduction study demonstrated improvement in sensory and motor responses. This case report identifies a peripheral nerve syndrome of a mononeuritis multiplex secondary to LNB in the absence of CSF pleocytosis with excellent outcome following antibiotic treatment. Peripheral nervous system manifestations of Lyme borreliosis can mimic a vasculitic neuropathy and therefore should be considered in individuals presenting with a painful mononeuritis multiplex.     

Effects of lithium on peripheral neuropathy induced by vincristine in rats

Vincristine (VCR) as a frequently used antimitotic agent which is commonly prescribed for wide spectrum of neoplasm, causes mixed sensorimotor neuropathy. Several evidences show lithium could be a neuroprotective agent, therefore to assess whether a pretreatment and at subtherapeutic dose it could prevent the peripheral neuropathy produced by VCR, rats were treated with VCR 0.1mg/kg i.p. for 3 alternative doses and / or lithium chloride (20mg/kg or 40 mg/kg i.p. daily from the first day to the day of sacrifice). Erythrocyte lithium concentration (ELC) and plasma lithium concentration (PLC) were measured at the seventh day of study and the day of scarification. After seventh day of lithium administration, PLC and ELC reached to a steady state at subtheraputic dose and they did not significantly change at normal housing situation. Hot plate, open field test and nerve conduction velocity were used to evaluate the sensory and motor neuropathy. Only VCR treated rats showed behavioral, electrophysiological and histological evidences of a mixed sensorimotor neuropathy by significant increase in hot plate latencies and a marked decrease in total distance moved and conduction velocities in both sensory and motor nerves. Lithium at the dose of 20mg/kg and specially 40mg/kg robustly reduced the rate of mortality, general toxicity and was able to ameliorate mixed sensorimotor neuropathy induced by VCR. These results suggest that lithium at dose of 20mg/kg and 40 mg/kg, potentially by its effects on cell survival pathways such as inhibition of glycogen synthase kinase-3 (GSK3β), can prevent both motor and sensory components of VCR neuropathy.     

75例2型糖尿病患者神经传导速度检测分析

目的:对2型糖尿病患者进行神经传导速度(NCV)检测,为糖尿病并发周围神经病变的早期诊断与治疗提供一项客观检测指标.方法:采用Viking IV肌电/诱发电系统仪对75例2型糖尿病患者的运动神经传导速度(MCV)和感觉神经传导速度(SCV)进行测定.结果:75例共测定周围神经300条,总异常率为54.3%,其中SCV的异常率(63.3%)高于MCV的异常率(45.3%),异常率比较有非常显著性差异(x2=9.79,P＜0.01).NCV异常率与年龄、上下肢无明显关系,而与病程长短有关.结论:NCV的改变是诊断糖尿病周围神经病变重要的早期客观指标,可作为糖尿病患者常规检查项目之一.     

糖尿病早期周围神经病变患者神经传导速度及定量感觉检查检测分析

目的 探讨糖尿病早期周围神经病变的神经电生理特点.方法 分别对175例无周围神经损害的糖尿病患者及50例健康人进行神经传导速度(NCV)及末梢感觉定量检查(OST)检测,并将结果进行对比分析.结果 175例糖尿病患者中,NCV异常率为7%(13/175),QST异常率为45%(79/175),两者比较差异有统计学意义(P<0.01).糖尿病患者与健康人比较运动传导速度、感觉传导速度差异无统计学意义(P>0.05);QST阈值中的冷觉、温觉、热痛觉差异有统计学意义(P<0.01).结论 对于糖尿病性周围神经病变QST较NCV的诊断敏感性高,提示其早期以小神经纤维受损更常见.     

Health effects among refrigeration repair workers exposed to fluorocarbons.

Refrigeration repair workers may be intermittently exposed to fluorocarbons and their thermal decomposition products. A case of peripheral neuropathy (distal axonopathy) in a commercial refrigeration repairman prompted an epidemiological investigation of the health of refrigeration repair workers. No additional cases of peripheral neuropathy were identified among the 27 refrigeration repair workers studied. A reference group of 14 non-refrigeration repair workers was also studied. No differences were noted between groups for the ulnar (motor and sensory), median (motor and sensory), peroneal, sural, or tibial nerve conduction velocities. Refrigeration repair workers reported palpitations and lightheadedness significantly more often than workers in the reference group. No clinical neurological or electroneurophysiological abnormalities were detected in eight refrigeration repair workers followed up for three years during continuous employment.     

二硫化碳对大鼠周围神经轴浆运输和能量代谢的毒作用效应

为研究二硫化碳（ＣＳ２）对周围神经系统的毒作用效应，用亚慢性染毒方式建立ＣＳ２所致周围神经病的大鼠模型后，采用同位素示踪技术和反向高效液相色谱法（ＲＰ－ＨＰＬＣ），分别测定了染毒组和对照组大鼠的坐骨神经中轴浆运输和能量代谢的变化。结果显示，同位素标记物３Ｈ－亮氨酸在亚慢性ＣＳ２中毒大鼠坐骨神经的运动和感觉神经中的运行距离均比对照组短；坐骨神经中ＡＴＰ、ＡＤＰ和ＡＭＰ的含量也均低于对照组。本研究表明ＣＳ２引起大鼠的周围神经损伤出现轴浆运输和能量代谢功能障碍。这些改变与ＣＳ２中毒性周围神经病在时间－剂量－反应上的关系尚待深入研究。