Because there are little satisfactory data on change in severity of diabetic polyneuropathy (DP) over time from study population-based cohorts patients epidemiologic surveys DP, it is difficult to predict outcome or morbidity identify risk factors; also estimate statistical power for use controlled clinical trials. In this longitudinal almost 200 the Rochester Diabetic Neuropathy Study (RDNS) cohort, we assess which symptoms, examinations, tests, combinations examinations and tests...

ERVE GROWTH FACTOR (NGF) is a protein that plays major role in the development and maintenance of peripheral nervous system.Nerve growth factor selectively promotes survival small fiber sensory neurons mediate pain, temperature sensation, sympathetic neurons. 1 Nerve expressed target tissues innervated by responsive neurons, where it binds to specific high-affinity receptors retrogradely transported back neuronal cell body. 2 Recent data suggest reduced availability NGF may play significant...

OBJECTIVE—The prevalence of autonomic symptoms and deficits in certain systems is known, but a comprehensive symptom profile diabetes not available. We aimed to estimate this using laboratory evaluation function validated self-report measure patients matched control subjects from the population-based Rochester Diabetic Neuropathy Study. RESEARCH DESIGN AND METHODS—Participants included 231 with (type 1, n = 83; type 2, 148) 245 healthy age-matched subjects. assessed instrument (Autonomic...

A cross-sectional survey and subsequent longitudinal study among diabetic residents of Rochester, MN--The Rochester Diabetic Neuropathy Study (RDNS)--is population-based uses quantitative, validated, unique end points to detect, classify, stage neuropathy. Nondiabetic persons, drawn from the same population, serve as controls. For patients 10 70 years old, RDNS cohort is representative diabetics living in MN. We assessed reproducibility tests used characterize quantitate severity neuropathy...

Normative data are limited on autonomic function tests, especially beyond age 60 years. We therefore evaluated these tests in a total of 557 normal subjects evenly distributed by and gender from 10 to 83 Heart rate (HR) response deep breathing fell with increasing age. Valsalva ratio varied both gender. QSART (quantitative sudomotor axon-reflex test) volume was consistently greater men (approximately double) progressively declined for all three lower extremity sites but not the forearm site....

Although peripheral neuropathy (PN) occurs after bariatric surgery (BS), a causal association has not been established.To ascertain whether PN more frequently following BS vs another abdominal surgery, to characterize the clinical patterns of PN, identify risk factors for and assess if nerve biopsy provides pathophysiologic insight.Retrospective review identified patients with BS. The frequency was compared that an age- gender-matched, retrospectively evaluated cohort obese undergoing...

We evaluated the initial assessments of 380 diabetic patients with and without polyneuropathy in Rochester Diabetic Neuropathy Study for (1) associations among neuropathy test results, (2) usefulness different tests diagnosing staging polyneuropathy, (3) appropriateness minimal criteria diagnosis (4) significant differences results increasing stage polyneuropathy. Nerve conduction ([NC]; abnormality two or more nerves) quantitative autonomic examination ([QAE]; decreased heartbeat response...

Sjögren9s syndrome (dryness of eyes, mouth, and other mucous membranes) may be associated with disease joints, blood, internal organs, skin, central peripheral nervous systems. We reviewed 33 cases primary neuropathy evaluated by neurologic examinations EMG at the Mayo Clinic from 1976 to 1988, studied sural nerve biopsy specimens in 11 them. Symmetric sensorimotor polyneuropathy occurred most frequently, followed symmetric sensory neuropathy. Autonomic neuropathy, mononeuropathy, or cranial...

Post-surgical neuropathies are usually attributed to mechanical factors, such as compression, stretch, contusion or transection. The role of inflammatory mechanisms in occurring after surgeries is poorly appreciated and not well characterized, may provide a rationale for immunotherapy. A total 23 selected patients with post-surgical received nerve biopsies, which 21 demonstrated increased inflammation. Here we report the clinical features these cases biopsy-confirmed 12 clinically suspected...

We recently found that vibratory detection threshold is greatly influenced by the algorithm of testing. Here, we study influence stimulus characteristics and testing estimating on cool (CDT), warm (WDT), heat-pain (HPDT) thresholds. show continuously decreasing (for CDT) or increasing WDT) thermode temperature to point at which cooling warming perceived signaled depressing a response key (“appearance” threshold) overestimates with rapid rates thermal change. The mean appearance disappearance...

Among 10 patients with amyotrophic lateral sclerosis who had combined biopsy of muscle and cutaneous nerves, two a history paresthesia that suggested involvement peripheral afferent neurons. Of four without paresthesia, unequivocal abnormalities touch-pressure sensation the toe. On morphometric evaluations fascicles deep peroneal nerve, one nerve an abnormally low myelinated fiber density seven high frequencies teased-fiber abnormalities. Teased fibers in which myelin was degenerating into...

In a series of 72 patients with disease peripheral neurons, neuropathic painfulness the foot was found to be related rate and kind nerve fiber degeneration. Patients acute breakdown myelinated fibers (either by wallerian or axonal degeneration) tend have pain more often greater degree than do chronic forms Neuropathic not simply ratio remaining large small after These studies fit expectation proponents gate theory pain.

Abstract In 5 patients with rheumatoid neuropathy of vascular etiology, nerve fibers showed axonal degeneration. One patient acute neuropathy, not receiving corticosteroids, had necrotizing arteritis; IgG, IgM, and β 1C, but albumin, were found in vessel walls. Patients chronic who received corticosteroids before biopsy proliferative endarteritis fibrinogen immunoglobulins the vessels. The arthritis probably represents healed stage an arteritis.

Diabetic lumbosacral radiculoplexus neuropathy is a subacute painful, asymmetrical lower limb due to ischaemic injury and microvasculitis. The occurrence of cervical diabetic has been postulated. Our objective was characterize the clinical features pathological alterations neuropathy, see if they are similar We identified patients with by review Mayo Clinic database from 1996 2008. systematically reviewed features, laboratory studies, neurophysiological findings, neuroimaging compared...

To test quantitative sensation testing (QST) patterns of hypoesthesia and hyperalgesia as indicators diabetic polyneuropathy (DPN) its severityWe used Computer-Assisted Sensory Examination IV; characterized the QST results foot each patient in three cohorts (approximately 1,500 patients) hyperesthetic (< or = 2.5th percentile), low-normal (2.5th-50th percentiles), high-normal (50th-97.5th hypoesthetic (> 97.5th percentile); tested associations with symptoms, impairments,...

We studied 46 consecutive patients with multifocal motor neuropathy conduction block (MMN-CB). Typically, asymmetric weakness and atrophy of the hands or arms developed insidiously, but spontaneous improvement (without treatment) death from this disease did not occur 94% remained employed. For 18 examined on multiple occasions using subscore impairment score [NIS(W)] for a median time 2.3 years, worsening 1.3 points per year was observed; many patients, however, had received intensive...

Quantitative sensory testing (QST) is based on well-developed psychophysical methods that define not only the stimulus (type, characteristics, quantity, presentation, format, and environment) but also response (form analysis). With availability of personal computers, transducers, electronic circuitry, specially written software, it became possible to develop systems delivered physical stimuli with waveforms were precisely defined, quantitated, graded over a broad range magnitudes, capable...