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Background Cyst enucleation, which extracts only the tumor with the application of Carnoy’s solution (CS), has been suggested as a conservative treatment with a low recurrence rate and morbidity. However, there has been a concern that CS’s contact with inferior alveolar nerve (IAN) can cause neurons to degenerate and cause sensory dysfunction. The purpose of this retrospective cohort study aimed to investigate the neurosensory function after surgical treatment with or without the application of CS. Methods While controlling the effects of sex, age, follow-up period, and invasion size of the tumor, we performed the binary logistic regression analysis to examine whether or not the sensory function of the patients who were treated with CS (n = 19) for the cyst enucleation procedure was significantly different from those who were not treated with CS (n = 58) at the end of the follow-up period. Results The logistic regression result showed that the use of CS was not significantly related to the normalness of sensory function at the end of the follow-up period. Rather, the invasion size of the cyst was significantly associated with sensory dysfunction. Conclusions CS may be used for patients who are diagnosed with OKC and UAM without much fear of its impact on sensory dysfunction. However, a small number of patients who were treated with CS experienced severe sensory damage and did not recover at the end of the follow-up period, suggesting the need for further analysis of these patients.

Introduction Guillain-Barré syndrome (GBS) is a worldwide demyelinating polyradiculopathy and polyneuropathy. Currently, there is no specific drug for GBS, and established treatment is generally based on immune-modulating treatment with plasma exchange or intravenous immunoglobulin in combination with supportive care. This study aimed to investigate the efficiency of integrated Chinese and Western medicine for acute GBS treatment. Methods We enrolled 73 subjects, and randomly divided them into two groups: 35 cases in the traditional Chinese medicine (TCM) group, and 28 in the Control group. The Control group was treated with the common Western medicine for one month; and the TCM group was administrated with one month of common treatment combined with TCM medication. Results Compared to the controls, TCM significantly enhanced the treatment efficiency in symptom expression, including the TCM syndrome score, the activity of daily living score, Hughes functional score and sensory dysfunction assessment. The total effective rate of the TCM group was 94.29%, significantly better than controls (78.59%). Moreover, TCM provide better improvement in motor nerve conduction functions (distal motor latency and motor conduction velocity) and sensory nerve conduction functions (sensory conduction velocity and sensory nerve action potential) in median nerve, ulnar nerve, and common fibular nerve. Conclusion When combined with TCM administration, the GBS treatment could acquire better outcomes.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease characterized by neurological symptoms and signs of progressive weakness, paresthesias, and sensory dysfunction. Other symptoms include reduced or absent tendon reflexes, cranial nerve involvement, autonomic symptoms, ataxia, and neuropathic pain. Unlike other autoimmune diseases, CIDP generally affects older individuals and has a male predominance. The onset is generally insidious and can take up to 8 weeks with a relapsing-recovery pattern. Like all autoimmune diseases, the etiology is multifactorial, with both genetic and environmental factors contributing to it. Case reports of CIDP have found associations with multiple pathogenic organisms including Hepatitis B and C viruses, Bartonella henselae, Mycoplasma pneumoniae, Human immunodeficiency virus, Cytomegalovirus and Epstein-Barr virus. Possible antigenic self-targets include myelin protein 0, myelin protein 2, peripheral myelin protein 22, Connexin 32, and myelin basic protein. Antibodies targeting the Ranvier node proteins such as contactin-1, contactin-associated protein 1, and neurofascin 155 have been described. CIDP is treated with rehabilitation and pharmacological modalities. Pharmacological treatments target autoimmune dysfunction and include corticosteroids, intravenous immunoglobulin, subcutaneous immunoglobulin, plasma exchange, immunosuppressive and immunomodulatory agents such as methotrexate, cyclophosphamide, rituximab, and mycophenolate mofetil. Although there are few observational studies and randomized clinical trials with limited evidence supporting the use of immunosuppressive drugs, they are widely used in clinical practice. A comprehensive review of CIDP is presented herein in light of the autoimmune tautology. © 2019 Elsevier Ltd

Sensory dysfunction is a core symptom of Autism Spectrum Disorder (ASD), and abnormalities with sensory responsivity and processing can be extremely debilitating to ASD patients and their families. However, relatively little is known about the underlying neuroanatomical and neurophysiological factors that lead to sensory abnormalities in ASD. Investigation into these aspects of ASD could lead to significant advancements in our general knowledge about ASD, as well as provide targets for treatment and inform diagnostic procedures. Thus, the current study aimed to measure the covariation of volumes of brain structures (i.e., structural magnetic resonance imaging; MRI) that may be involved in abnormal sensory processing, in order to infer connectivity of these brain regions. Specifically, we quantified the structural covariation of sensory-related cerebral cortical structures, in addition to the cerebellum and amygdala by computing partial correlations between the structural volumes of these structures. These analyses were performed in participants with ASD (n = 36), as well as typically developing peers (n = 32). Results showed decreased structural covariation between sensory-related cortical structures, especially between the left and right cerebral hemispheres, in participants with ASD. In contrast, these same participants presented with increased structural covariation of structures in the right cerebral hemisphere. Additionally, sensory-related cerebral structures exhibited decreased structural covariation with functionally identified cerebellar networks. Also, the left amygdala showed significantly increased structural covariation with cerebral structures related to visual processing. Taken together, these results may suggest several patterns of altered connectivity both within and between cerebral cortices and other brain structures that may be related to sensory processing. □

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Neuromyelitis optica (NMO) or Devic's disease is an autoimmune inflammatory demyelinating condition affecting the central nervous system (CNS). It was initially believed to be a variant of multiple sclerosis (MS). However, the discovery of NMO-IgG anti-AQP4 antibodies marked an objective distinction between these conditions. Treatment of acute attacks is generally based on pulsed steroids, followed by long-term immunosuppression with azathioprine, oral steroids, and rituximab as first-line therapies. Plasma exchange therapy is indicated for steroid-resistant relapses. We describe a case report of a pregnant woman with a severe relapse of Devic's disease, initially misdiagnosed as MS, unresponsive to pulsed steroids, and who underwent plasma exchange therapy safely, with excellent clinical response and with no adverse outcome for the fetus. © 2016 Elsevier B.V.

Studies were performed on a large number of diabetic patients with three levels of plantar sensation loss by analysing walking foot pressure images in the frequency domain. The feet of diabetic subjects were scanned over ten specified areas using Semmes-Weinstein's nylon monofilaments to determine quantitatively the three levels of neuropathy. A new parameter, the power ratio (PR, ratio of high frequency power to the total power in an image) was used to distinguish discretely between normal and diabetic feet in three levels of sensation loss. Analysis of results showed that the differences in PR values for diabetic feet (in all three levels of sensation loss) compared to normal feet were found to be highly significant (p

WOS: 000260847300024, PubMed ID: 17965909, Syringomyelia, which is generally related to congenital malformations and tumors, may lead to paresthesia and dysfunctions in thermo-algesic perception. Post-traumatic syringomyelia (PTS) is a rare type of this disease characterised by the development of a cystic formation containing cerebrospinal fluid (CSF), which develops inside the spinal cord after spinal trauma. The description of a case diagnosed as painless burn injury caused by PTS. One case report. Although there are a number of reports regarding the formation of neuropathic ulcers related to syringomyelia, painless burn injury descriptions are very rare. Despite available limited data related to this subject, it is important to warn patients about traumas-especially burns-after a diagnosis of PTS.

Objective: The aim of the study was to assess pain threshold and tolerance in diabetics with/without neuropathy and to compare that in with healthy controls. Methods: In this cross-sectional and comparative study, 79 diabetics (57 without neuropathy and 22 with neuropathy) and 32 healthy controls (63 women and 48 men) with a mean age of 48.11±7.52 years were studied. Seventy-nine diabetics, aged 33 to 74, who met inclusion criteria were evaluated using electrical stimulation (faradic current) to assess pain threshold and tolerance on upper and lower extremities and were compared with healthy controls. They also were evaluated using Michigan Neuropathy Screening Index (MNSI), 5.07 mmg Semmes Weinstein Monofilament, and visual analog scale (VAS). Pain threshold and tolerance were measured experimentally. Results: Of all participants, 32.4% had pain complain. Eighteen diabetics without neuropathy (31.6%) and 9 diabetics with neuropathy (40.9%) reported pain. The result of upper and lower extremities' pain threshold and tolerance showed that there was a significant difference between diabetics and healthy participants (P

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:21:10Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:39:50Z : No. of bitstreams: 1 2-s2.0-10644263663.pdf: 71880 bytes, checksum: 5818b4d38d74a593babc54b276f5c71c (MD5) Made available in DSpace on 2014-05-27T11:21:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-11-01 BACKGROUND AND OBJECTIVES: Before epídural steroids were used in chronic lumbar pain, subarachnoid injection of these agents was the treatment of choice. Although still preconized by some authors, this technique may lead to severe complications with neurological sequelae. This report aimed at describing a case of accidental subarachnoid injection of steroid associated to local anesthetics during epidural puncture to treat lumbar pain. CASE REPORT: Male patient, 46 years old, followed byneuro-surgery for presenting right sciatic pain for 9 month, refractory to clinical treatment due to L 4-L 5 disk protrusion confirmed by CT scan, without neurological deficit. Epidural puncture for pain treatment was performed in L 4-L 5 with 17G needle and 10 mL solution were injected containing 4 mL of 0.25% bupivacaine, 80 mg methylprednisolone and 4 mL of 0.9% saline. Although there has not been CSF reflux, 5 minutes after injection there were sensory block in T 4 and motor block in T 6, associated to blood pressure and heart rate decrease. CONCLUSIONS: Accidental subarachnoid injections with the association of steroids for pain relief may cause adverse effects. There are several risks, varying from mild transient symptoms to nervous injuries, including spinal cord injuries. Our patient had no sequelae from the accidental subarachnoid injection, probably because it has been a single injection. CET/SBA Depto. de Anestesiol. da FM - UNESP Ctro. Paulista de Cir. Plast. de Jau , Rua Jamil Sarkis, 135, Jardim Alvorada 17210-39O Jau, SP CET/SBA Depto. de Anestesiol. da FM - UNESP

This paper presents the results of the study undertaken on diabetic neuropathic subjects to find the relationship between the standing foot pressure parameter, power ratio (PR, ratio of high frequency power to the total power in the power spectrum of standing foot pressure image distribution obtained by optical pedobarograph), the foot sole hardness, and foot sole thicknesses at different levels of sensation loss. Spatial frequency distributions in the standing foot pressure images are analyzed to calculate the PR in each foot sole area for different levels of foot sole sensation loss and mechanical properties of foot sole hardness and thicknesses. The results show that the increase in PR in the upper foot sole hardness or Shore levels (30-40) is 1.4-3.7 times the corresponding increase in lower Shore levels (20-30), implying a higher possibility of development of plantar ulcers when the plantar surface becomes hard, combined with increase in sensation loss. It is observed that plantar ulcers are found to develop (i) for foot sole hardness or Shore values of 30 at sensation level of 4.5 gm and (ii) for Shore values of 40 and above at sensation levels of 10 and >10 gm, PR being high (29, 48 and 58, respectively) and the foot sole thicknesses are also greater than the corresponding normal values. Thus, different degrees of increase of all the three factors, namely, hardness, thickness and foot pressure distribution parameters in different levels of loss of foot sole sensation (or degrees of neuropathy) contribute to formation of foot sole ulcers in diabetic subjects. ? 2003 Elsevier SAS. All rights reserved.

The infiltration of the leptomeninges by malignant cells is not an uncommon complication of cancer and is called carcinomatous meningitis or leptomeningeal carcinomatosis (LC). Carcinomatous meningitis arises from either solid tumours or haematological malignancies. In general, LC represents a devastating metastatic complication of systemic malignant disease with a dismal prognosis and increased mortality. The diagnosis is made by both lumbar puncture and radiological investigation, mainly magnetic resonance imaging (MRI). The most common associated malignancies are breast and lung cancer, melanoma, lymphomas and leukaemias [1, 2]. The therapeutic management of LC includes intrathecal administration of chemotherapy and radiotherapy. The treatment of LC remains controversial and no straighforward guidelines exist in the literature. The present article reviews the incidence, pathogenesis, clinical presentation, diagnosis and treatment of LC in all malignancies.

Aim: In this study we determined the protective role of amifostine against the side effects of the combination of paclitaxel and carboplatin in patients with non-small cell lung cancer (NSCLC). Patients and Methods: Chemo-naive patients with NSCLC were eligible. Thirty-eight patients were randomized to receive paclitaxel 175 mg/m2 and carboplatin AUC=6 with amifostine 910 mg/m2 (group B) or chemotherapy alone (group A). The occurrences of hematologic, neurologic, cardiologic toxicities, and ototoxicity were evaluated. Results: All patients completed the six scheduled cycles of therapy. A total of 114 cycles of chemotherapy was given in both groups. Neutropenia grade 3–4 was observed in 11 cycles (9.6%) in group A and 19 cycles (16.6%) in group B (p=0.16). Paresthesia grade 1 or 2 was observed in 18 of 19 patients of group A and in 8 of 19 patients of group B, following the sixth cycle of chemotherapy (p=0.018). Two patients of group B and nine patients of group A suffered from sensory motor impairment grade 2 (p=0.029). There was no clinical evidence in any patient for deterioration in cardiac function. Asymptomatic and transient sinus bradycardia or ventricular premature beats developed in four patients. None of the patients reported vertigo, tinnitus, or hearing loss. Conclusion: The addition of the amifostine to the combination of paclitaxel and carboplatin may prevent or reduce the incidence of neurotoxicity in the treatment of NSCLC. Amifostine does not appear to have a preventive role in neutropenia.

Accumulating evidence over the past decade indicates that synthetic retinoids may be capable of affecting both growth and differentiation of nervous tissue. Our aim was to substantiate possible side-effects of oral isotretinoin therapy on peripheral nerve functions, both neurologically and neurophysiologically. We performed neurological examination and electroneuromyographic studies on 18 patients with various skin diseases before, at the third month, and at the end of isotretinoin treatment. Abnormal neurophysiological findings in this study point towards a typical distal, length-dependent and predominantly sensory polyneuropathy. Clinicians should be aware of possible neurological sensorial symptoms during isotretinoin therapy. In our opinion, electroneuromyographic investigation should be performed on all patients reporting symptoms (e.g. paresthesia, numbness, sensory loss) before and during oral isotretinoin treatment. The precise clinical significance of the isotretinoin-induced neurophysiological alterations reported here remains to be determined in further studies.