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Background: Nerve damage can be autoimmune inflammatory, metabolic or traumatic, among others, and can be difficult to differentiate. Objective: What are the advantages of interdisciplinary networks and how do they work? Material and method: Field report with case presentation from the University Hospital Tübingen in cooperation with the BG Accident Clinic Tübingen. Conclusion: Interdisciplinary networks improve the care of our patients and also serve as regular multidisciplinary continuing education. [ABSTRACT FROM AUTHOR]

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Summary: Suprascapular nerve neuropathy is becoming increasingly recognized as a reason for persistent shoulder pain. The underlying cause may be iatrogenic, as in the case of our patient, or due to ganglionic compression or traction. Unfortunately, diagnosis and thus adequate therapy is frequently delayed. With this case study, we would like to bring the neuropathy of the suprascapular nerve into focus for the general practice. [ABSTRACT FROM AUTHOR]

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Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Neurological sequelae of cytostatic chemotherapy are a growing medical problem as the number of patients suffering from malignant diseases is steadily increasing. Objectives: Chemotherapy-induced neuropathies (CIN) are among the most common side effects of many cytostatic drugs. Awareness of symptoms, diagnosis and treatment of these conditions are therefore highly relevant. Methods: A review of the primary and secondary literature was carried out. Results: This article reviews the literature on neuropathies induced by frequently used cytostatic drugs and discusses diagnostic, preventive and therapeutic strategies. Specifically, this review focuses on antibody-drug conjugates, platinum-based antineoplastic drugs, proteasome inhibitors, taxanes and vinca alkaloids. The lack of well-established preventive and therapeutic strategies complicates the management of CINs. The most successful approaches to CIN prevention are modifications of the treatment regime including single and cumulative doses, frequency and mode of infusion. Current evidence favors duloxetine as a symptomatic treatment of platinum-induced neuropathies. Conclusion: The CINs are an unsolved medical problem. Knowledge of symptoms as well as preventive, diagnostic and therapeutic strategies is important when patients present in clinical practice with neurological symptoms following chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Diabetic neuropathy is a common complication of diabetes mellitus. The length-dependent symmetrical sensorimotor type of neuropathy is the most prevalent form of diabetic neuropathy but other forms of diabetic neuropathy also need to be kept in mind. Their differential diagnosis is often more challenging but implicates specific forms of treatment other than improvement of metabolic control. Aim of the study: This article gives an overview of the less frequent forms of diabetic neuropathy and discusses their impact, diagnostic and therapeutic implications. Results: Autonomic diabetic neuropathy, diabetic small fiber neuropathy and less frequent forms of diabetic neuropathy, such as diabetic radiculoplexopathy, diabetic neuropathy of cranial nerves, therapy-induced neuropathy and alternative causes of peripheral neuropathy in patients with diabetes are described. Discussion: Diagnosis of less frequent subtypes of diabetic neuropathy and differentiation towards alternative causes of peripheral neuropathy are often difficult in daily medical routine. Diagnostic clues are helpful in identifying rarer forms of diabetic neuropathy, thus enabling more specific treatment. [ABSTRACT FROM AUTHOR]

Altogether, nerve entrapment syndromes have a very high incidence. Neurological deficits attributable to a focal peripheral nerve lesion lead to the clinical diagnosis. Frequently, pain is the dominant symptom but is often not confined to the nerve supply area. Electroneurography, electromyography, and more recently also neurosonography are the most important diagnostic tools. In most patients surgical therapy is necessary, which should be carried out in a timely manner. The entrapment syndromes discussed are suprascapular nerve entrapment, carpal tunnel syndrome, cubital tunnel syndrome, meralgia paraesthetica, thoracic outlet syndrome and anterior interosseous nerve syndrome. [ABSTRACT FROM AUTHOR]

Axon-reflex-based tests of peripheral small nerve fiber function including techniques to quantify vasomotor and sudomotor responses following acetylcholine iontophoresis are used in the assessment of autonomic neuropathy. However, the established axon-reflex-based techniques, laser Doppler flowmetry (LDF) to assess vasomotor function and quantitative sudomotor axon-reflex test (QSART) to measure sudomotor function, are limited by technically demanding settings as well as interindividual variability and are therefore restricted to specialized clinical centers. New axon-reflex tests are characterized by quantification of axon responses with both temporal and spatial resolution and include 'laser Doppler imaging (LDI) axon-reflex flare area test' to assess vasomotor function, the quantitative direct and indirect test of sudomotor function (QDIRT) to quantify sudomotor function, as well as the quantitative pilomotor axon-reflex test (QPART), a technique to measure pilomotor nerve fiber function using adrenergic cutaneous stimulation through phenylephrine iontophoresis. The effectiveness of new axon-reflex tests in the assessment of neuropathy is currently being investigated in clinical studies. [ABSTRACT FROM AUTHOR]

Hereditary amyloidosis is an autosomal dominant fatal multisystem disease caused by extracellular deposition of misfolded proteins and, therefore represents a hereditary protein folding or deposition disease that leads to progressive organ damage and eventually death. In most instances mutations within the transthyretin gene are the underlying cause. The main manifestation is a rapidly progressing axonal sensorimotor and autonomic polyneuropathy (familial amyloid polyneuropathy, FAP). Cardiac involvement is frequent in FAP and additional manifestations include the gastrointestinal tract and the eyes. A second manifestation type is cardiomyopathy with little or no polyneuropathy (familial amyloid cardiomyopathy, FAC). For therapy, orthotopic liver transplantation has been established for 25 years. Recently, the oral agent tafamidis, a transthyretin stabilizer, was licensed for treatment of stage 1 polyneuropathy. Additional treatment options are currently being studied. [ABSTRACT FROM AUTHOR]

[english] Introduction: Postoperative neurological complications in pelvic and renal surgery are a well-known clinical problem and their morbidities are important. We designed this study to determine prevalence and risk factors of such complications after percutaneous nephrolithotomy (PCNL) surgery.Material and methods: A cross-sectional study was performed during February and July 2011 on 68 PCNL cases. Demographic data and surgery reports were gathered and comprehensive neurological physical examination carried out before and after surgery. Then, data was analyzed using software SPSS 18. Results: The ultimate sample included 30 (46.2%) male and 35 (53.8%) female patients with a mean age of 47.9 ± 11.47 years. In intercostal and lumbosacral plexus area, sensory neurological complications occurred in 8 patients (12.31%), 4 men and 4 women. The most common involved dermatomes and nerves were T12 (8 cases). There was a significant correlation between prolonged duration of surgery and prevalence of sensory complications (p[german] Einleitung: Postoperative neurologische Komplikationen bei operativem Eingriff an Becken und Niere sind ein bekanntes klinisches Problem und deren Krankheitsverläufe sind wichtig. Wir planten diese Studie, um die Prävalenz und die Risikofaktoren derartiger Komplikationen nach perkutaner Nephrolithotomie (PCNL) zu erfassen.Material und Methoden: Von Februar bis Juli 2011 wurde eine Querschnittstudie an 68 PCNL-Fällen durchgeführt. Die demographischen Daten und die Operationsberichte wurden ausgewertet und umfassende neurologische und körperliche Untersuchungen wurden vor und nach dem chirurgischen Eingriff vorgenommen. Die Daten wurden mit der Software SPSS 18 analysiert.Ergebnisse: In die Studie einbezogen wurden 30 männliche (46,2%) und 35 (53,8%) weibliche Patienten mit einem mittleren Alter von 47,9 ± 11,47 Jahren. Bei 8 Patienten (12,31%), bei 4 Männern und 4 Frauen, wurden im Bereich des interkostalen und lumbosakralen Plexus sensorische neurologische Komplikationen gefunden. Die am häufigsten betroffenen Dermatome und Nerven waren im Bereich T 12 (8 Fälle). Es gab eine signifikante Korrelation zwischen der Dauer des chirurgischen Eingriffes und dem Vorkommen von sensorischen Komplikationen (p

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Zusammenfassung: Nervenultraschall hat sich in den letzten Jahren in der Neurologie zu einem vielgefragten und beachteten Diagnostikum entwickelt. Vor allem bei der Darstellung häufiger Engpasssyndrome wie dem Karpal- und dem Kubitaltunnelsyndrom, aber auch bei traumatologischen Nervenverletzungen und Nerventumoren hat sich die hochauflösende Sonografie mit 12-20 MHz-Sonden zu einer Standarddiagnostik entwickelt. Viel Beachtung fanden zuletzt Veröffentlichungen zur Darstellung von fokalen und generalisierten Nervenschwellungen bei immunvermittelten Neuropathien wie der CIDP (chronisch inflammatorische und demyelinisierende Polyneuropathie), dem GBS (Guillain-Barré-Syndrom) und der MMN (multifokale motorische Neuropathie). Während derartige Phänomene bei hereditären Neuropathien wie der CMT1 (Charcot-Marie-Tooth) bereits vor längerer Zeit beschrieben wurden, bietet diese Erkenntnis der letzten Jahre neue Perspektiven in der Diagnostik von Neuropathien. Insbesondere eine Unterscheidung von demyelinisierenden und axonalen Neuropathien gelingt mittels Elektrophysiologie nicht immer zweifelsfrei. Diese Arbeit soll daher einen Überblick über die bisherige Literatur bieten, ob und inwieweit Nervenultraschall bei der Untersuchung von Neuropathien einen Zugewinn liefert. [ABSTRACT FROM AUTHOR]

Chronische Rückenschmerzen weisen neben einer nozizeptiven hãufig auch eine neuropathische Komponente auf. Ob dies bei einem spezifischen Patienten der Fall ist, lâsst sich beispielsweise mittels eines Fragebogens wie dem PainDETECT ermitteln. Die Behandlung dieser gem ischten Schmerzen setzt idealerweise an beiden Kompo- nenten an. Aufgrund seiner Wirkung als μ-Opioid-Rezeptoragonist (MOR) und Noradrenalin-Wiederaufnahme- hemmer (NRI) erfüllt Tapentadol diese Voraussetzungen. In verschiedenen klinischen Studien bei Patienten mit Rücken-, aber auch Osteoarthroseschmerzen, konnte denn auch eine gute analgetische Wirkung, auch im Vergleich zu anderen starken Analgetika, bei einer besseren Verträglichkeit festgestellt werden. [ABSTRACT FROM AUTHOR]

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Copyright of Neurophysiologie-Labor is the property of Elsevier GmbH, Urban & Fischer Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hereditary neuropathies belong to the most common neurogenetic disorders. They appear mostly as sensory and motor neuropathies but there are also pure sensory, pure motor as well as sensory and autonomic hereditary neuropathies. In clinical practice, knowledge of hereditary neuropathies is important in order to recognize them among polyneuropathies and achieve a successful genetic diagnosis. The molecular genetics of hereditary neuropathies are very heterogeneous with currently more than 40 known disease-causing genes. The 4 most common genes account for almost 90% of the genetically diagnosed hereditary neuropathies. In this review article we provide an overview of the currently known genes and propose a rational genetic work-up protocol of the most common genes. [ABSTRACT FROM AUTHOR]

The differential diagnosis of focal neuropathy continues to be one of the main tasks in peripheral neurology and clinical neurophysiology. In this respect a detailed medical history a topologically oriented clinical examination based on profound anatomical knowledge and a targeted neurophysiological examination are the cornerstones of successful diagnosis. Refined imaging techniques, such as sonography and magnetic resonance imaging provide - additional and valuable morphological information especially in atypical or unresolved cases. The aim of this overview is therefore to summarize the spectrum of focal neuropathy and diagnostic approaches, particularly in terms of a well-founded differential diagnosis. [ABSTRACT FROM AUTHOR]

During the course of cancer progression up to 90% of the patients suffer from pain of nociceptive, neuropathic or mixed nociceptive/neuropathic origin. Psychological, social or existential factors may additionally affect the intensity of pain (concept of 'total pain'). The WHO 'analgesic ladder' provides a large variety of effective drugs that can be used according to the specific pain type. Parenteral or peridural opioid therapy as well as neurodestructive methods can effectively support the analgesic treatment in selected cases. [ABSTRACT FROM AUTHOR]

My hands are numb is a common complaint in primary care. Generally, carpal tunnel syndrome can be suspected. This case report explains typical aspects of clinical reasoning used by neurologists to confirm the diagnosis, and also provides some details of "red flags" based on history and examination. Additionally, a short introduction to electrodiagnostic procederes is included and illustrated with diagrams. [ABSTRACT FROM AUTHOR]

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Copyright of Neurophysiologie-Labor is the property of Elsevier GmbH, Urban & Fischer Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archiv für Kriminologie is the property of Schmidt-Roemhild Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Perioperative visual loss (POVL) after nonocular surgery is a rare but unexpected event and represents a devastating complication. It is most often associated with cardiac, spinal as well as head and neck surgery. The etiology of POVL remains incompletely understood. Any portion of the visual system may be involved, from the cornea to the occipital lobe. The most common site of permanent injury is, however, the optic nerve itself and ischemia is the most often presumed mechanism. Multiple factors have been proposed as risk factors for POVL, including long duration in the prone position, decreased ocular perfusion pressure, excessive blood loss and anemia, hypotension, hypoxia, excessive fluid replacement, elevated venous pressure, head positioning and a patient-specific vascular susceptibility which may be anatomic or physiologic. However, the risk factors for any given patient or procedure may vary. The underlying specific pathogenesis of these neuro-ophthalmic complications remains unknown and physicians should be alert to the potential for loss of vision in the postoperative period. This review updates readers on the incidence, suspected risk factors, diagnosis and treatment of POVL in the setting of nonocular surgery. [ABSTRACT FROM AUTHOR]

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Background: Critical Illness Myopathy and Neuropathy (CRIMYN) frequently coexist with severe sepsis and is associated with prolonged weaning from mechanical ventilation and prolonged ICU length of stay. We aimed to classify different levels as well as patterns of impairment with regard to electrophysiological disturbances in CRIMYN patients by cluster analysis. Methods: A total of 30 patients with sepsis/SIRS were studied prospectively. Motor and sensory conduction studies were performed from six motor and four sensory nerves on a weekly basis from admission until discharge and finally after 6 months. A control group of 63 healthy persons was examined simultaneously using the same criteria. Different patterns of electrophysiological disturbances were classified by cluster analysis based on differences to reference values of 20 parameters, compound muscle action potential (CMAP), sensory nerve action potential (SNAP) and motor and sensor conduction velocity (NCV). Results: Four different clusters were identified: cluster 1 showing normal values for CMAP, SNAP and NCV in all nerves (3 patients and all test persons), cluster 2 showing pathological values for CMAP in the lower extremities and the other parameters were normal (5 patients), cluster 3 showing moderately pathological values for CMAP, SNAP and sensory NCV in upper and lower extremities and motor NCV in lower extremities (12 patients) and cluster 4 showing severe disturbances of CMAP, SNAP and NCV in upper and lower extremities (10 patients). Conclusion: A total of four different clusters of electrophysiological impairment can be identified in patients with sepsis/SIRS, which enables further differentiation of the severity of neuromuscular disturbances in sepsis-associated organ failure. This might be useful as a prognostic parameter and can be correlated with additional clinical and paraclinical parameters related to sepsis. [ABSTRACT FROM AUTHOR]

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Human immunodeficiency virus (HIV)-associated polyneuropathy has become the most common neurological complication of HIV infection and is one of the main risk factors for development of a neuropathy worldwide. Therefore HIV should always be considered as an underlying cause in patients with neuropathy. Many types of peripheral neuropathies are seen in HIV infection depending on the stage of infection. The inflammatory demyelinating neuropathies both acute (Guillain-Barré syndrome, GBS) and chronic (chronic inflammatory demyelinating neuropathy, CIDP) occur mainly at the time of seroconversion or early in the course of the disease while syndromes associated with opportunistic infections like CMV (i.e. polyradiculoneuropathy) occur in the late phase of HIV infection and are related to the loss of immune function. Distal symmetrical polyneuropathy (DSP) is the most common neuropathy in HIV-infected patients. We review the clinical manifestations, epidemiology, clinical diagnostics, pathophysiology and management strategies for HIV-associated polyneuropathies. [ABSTRACT FROM AUTHOR]

The aim of this multi-centre, longitudinal investigation was to document the efficacy and tolerability profiles of controlled release hydromorphone in patients with heavy visceral, somatic or neuropathic pain under practical conditions. To this end, a prospective observational study was conducted in 57 centres in Switzerland, on a total of 196 patients. After an average of 43 days of treatment with controlled release hydromorphone, the intensity of momentary pain dropped by 46.5% and that of maximum pain dropped by 41.3%, with the efficacy of the treatment being most pronounced with visceral and somatic pain. At the same time, the prevalence of sleep disorders as a result of pain decreased from initially 86.7% to 21.0%. Controlled release hydromorphone was excellently tolerated in this group of elderly (average age 70.6 years), multimorbid pain patients receiving various medical treatments (average of 2.4 drugs in addition to pain medication), even in the voluntary long-term extension study of up to 96 days. No medical interactions were reported. Six and thirteen weeks after introducing the treatment, 89.8% and 85.2%, respectively, were still taking controlled release hydromorphone. Controlled release hydromorphone is a recommendable option for practical treatment of heavy and extremely heavy pain of various genesis. [ABSTRACT FROM AUTHOR]

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Outpatient follow-up after intensive care unit (ICU) treatment is becoming increasingly important. The most relevant medical problems after hospital discharge are usually not directly linked to the medical condition that made intensive care necessary. The most frequent medical problem is muscle weakness. Joint contractures, pressure neuropathies, scars and hair loss can be painful, immobilising and troublesome, respectively. Chronic hoarseness, tracheomalacia, or tracheal stenosis are potential sequelae after tracheostomy. Renal dysfunction can persist after renal failure. Furthermore, posttraumatic stress disorder, panic attacks and sleep disturbances can limit the patients. Many of these problems last for months or more, the therapy is often challenging, and an interdisciplinary approach is warranted. Consequently, quality of life is generally reduced in ICU survivors. [ABSTRACT FROM AUTHOR]

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Copyright of Der Diabetologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)