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[PMID]: 29221755
[Au] Autor:Robnik B; Kese D; Rojko T; Horvat-Ledinek A; Praznikar A; Beovic B
[Ad] Address:Department of Infectious Diseases, University Medical Centre Maribor, Maribor, Slovenia.
[Ti] Title:Unilateral brachial plexopathy, a rare complication of Mycoplasma pneumoniae infection.
[So] Source:J Infect Chemother;24(4):309-311, 2018 Apr.
[Is] ISSN:1437-7780
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Few reports in the literature describe isolated peripheral neuropathies in relation to Mycoplasma pneumoniae infection without concurrent damage to the central nervous system. To our knowledge only a single case of mononeuritis multiplex with brachial plexus neuropathy coincident with M. pneumoniae has been documented until now. Here we present the first clinical case of lobar M. pneumoniae pneumonia in a 19-year-old female patient, where coincident neurological complications manifested as unilateral brachial plexus neuropathy, affecting axillar and suprascapular nerves. Isolated M. pneumoniae from sputum belonged to P1 type 2 and to MLVA type 3-6-6-2. No mutation associated with macrolide resistance in domain V of the 23S rRNA gene was detected. Serological testing of a GM1 antibody showed positive results, which might support the role of immunologic mechanisms in the pathogenesis of peripheral neuropathies related to M. pneumoniae infection.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Process

  2 / 3890 MEDLINE  
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[PMID]: 29400678
[Au] Autor:Milicin C; Sîrbu E
[Ad] Address:Department of Balneophysiotherapy and Rehabilitation Medicine, University of Medicine and Pharmacy "Victor Babes" Timisoara, Timisoara, Romania.
[Ti] Title:A comparative study of rehabilitation therapy in traumatic upper limb peripheral nerve injuries.
[So] Source:NeuroRehabilitation;42(1):113-119, 2018.
[Is] ISSN:1878-6448
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Lower motor neurons are the only neurons of the central nervous system (CNS) with the ability to regenerate without any intervention after an axotomy. AIM: This present study was conducted to analyze clinical and electrophysiological parameters in four groups of upper limb peripheral neuropathies, before and after treatment, comparing the results obtained after three cures of complex rehabilitation therapy. MATERIALS AND METHODS: We selected a number of 107 patients (66 women and 41 men) aged between 29 and 77 years (mean age = 49.6). Clinical (muscular strength, sensitivity) and electrophysiological parameters (accommodation coefficient α, nerve conduction velocity) were analyzed. All patients received 3 comprehensive treatment cures, each cure of 14 days and a rest period of 3 months between the cures. RESULTS: From the total of 107 patients included in the study, 52 were diagnosed with brachial plexus palsy, 27 with radial nerve palsy, 18 with median nerve palsy and 10 with ulnar nerve palsy. We did not observe a statistically significant difference between the mean age of males (47.2) and females (51.2) (p = 0.07), but peripheral neuropathies were more common in young males. At the end of the rehabilitation treatment all patients achieved better outcomes in muscle strength, sensitivity, adjustment coefficient α and nerve conduction velocity (p < 0.001).CONCLUSIONThe intervention of a physical therapy program in patients with peripheral neuropathies provided significantly better outcomes in clinical and electrophysiological parameters. Our rehabilitation protocol can be considered an alternative in order to stimulate and accelerate the nerve regeneration process.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180205
[Lr] Last revision date:180205
[St] Status:In-Process
[do] DOI:10.3233/NRE-172220

  3 / 3890 MEDLINE  
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[PMID]: 29307357
[Au] Autor:Gwathmey KG
[Ad] Address:Department of Neurology, University of Virginia, Charlottesville, VA, United States. Electronic address: kgg2p@virginia.edu.
[Ti] Title:Plexus and peripheral nerve metastasis.
[So] Source:Handb Clin Neurol;149:257-279, 2018.
[Is] ISSN:0072-9752
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:Cancer in the form of solid tumors, leukemia, and lymphoma can infiltrate and metastasize to the peripheral nervous system, including the cranial nerves, nerve roots, cervical, brachial and lumbosacral plexuses, and, rarely, the peripheral nerves. This review discusses the presentation, diagnostic evaluation, and treatment options for metastatic lesions to these components of the peripheral nervous system and is organized based on the anatomic distribution. As skull base metastases (also discussed in Chapter 14) result in cranial neuropathies, these will be covered in detail, as well as cancers that directly infiltrate the cranial nerves. Particular emphasis is placed on the clinical, imaging, and electrodiagnostic features that differentiate neoplastic plexopathies from radiation-induced plexopathies. Neurolymphomatosis, in which malignant lymphocytes invade the cranial nerves, nerve roots, brachial and lumbosacral plexuses, and peripheral nerves, is a rare manifestation of lymphoma and leukemia. Diagnoses of neurolymphomatosis are often missed or delayed given its varied presentations, resulting in poorer outcomes. Thus this disease will also be discussed in depth.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180108
[Lr] Last revision date:180108
[St] Status:In-Process

  4 / 3890 MEDLINE  
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[PMID]: 29202391
[Au] Autor:Herraets IJT; Goedee HS; Telleman JA; van Asseldonk JH; Visser LH; van der Pol WL; van den Berg LH
[Ad] Address:Department of Neurology, Brain Center Rudolf Magnus, UMC Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Neurology and Clinical Neurophysiology, Elisabeth-Tweesteden Hospital, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands. Electronic address: i.j.t.herraets@umcu
[Ti] Title:High-resolution ultrasound in patients with Wartenberg's migrant sensory neuritis, a case-control study.
[So] Source:Clin Neurophysiol;129(1):232-237, 2018 Jan.
[Is] ISSN:1872-8952
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Wartenberg's migrant sensory neuritis (WMSN) is a rare, patchy, pure sensory neuropathy of unknown etiology. High-resolution ultrasonography (HRUS) is an emerging diagnostic technique for neuropathies, but it has not been applied in WMSN. In this study we aimed to determine HRUS abnormalities in WMSN. METHODS: We performed a case-control study of 8 newly diagnosed patients with WMSN and 22 treatment-naive disease controls (16 patients with pure sensory axonal neuropathy and 6 with pure sensory chronic inflammatory demyelinating polyneuropathy (CIDP) or Lewis-Sumner syndrome (LSS)). All patients underwent routine diagnostic evaluations and a predefined HRUS protocol. RESULTS: We found multifocal nerve enlargement in all 8 WMSN patients. The median nerve in the upper arm and the sural nerve were significantly larger in WMSN than in axonal controls (p = 0.01 and p = 0.04). In CIDP/LSS, sonographic enlargement was more extensive. Furthermore we found brachial plexus involvement in 3 of 8 (38%) WMSN patients. CONCLUSION: HRUS showed enlargement of multiple nerves in all WMSN patients even if clinical testing and NCS were normal. SIGNIFICANCE: The feature of multifocal nerve enlargement may be of additional value in establishing the diagnosis of WMSN and may support the suggestion of an auto-immune etiology.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171226
[Lr] Last revision date:171226
[St] Status:In-Data-Review

  5 / 3890 MEDLINE  
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[PMID]: 29157770
[Au] Autor:Duffy BJ; Tubog TD
[Ti] Title:The Prevention and Recognition of Ulnar Nerve and Brachial Plexus Injuries.
[So] Source:J Perianesth Nurs;32(6):636-649, 2017 Dec.
[Is] ISSN:1532-8473
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Perioperative peripheral nerve injury is a serious yet preventable perioperative complication. Since the inception of the American Association of Anesthesiologists Closed Claim Project, the incidence of peripheral nerve injury has remained constant with an overall reported prevalence rate of 15% to 16%. To date, the most frequent nerve injuries are ulnar nerve neuropathy and brachial plexus injury. This article will review the clinical presentation, pathophysiology, causative and risks factors, and preventive measures for the two most common nerve injuries. Knowledge of the anatomical structures and components of peripheral nerves prone to injuries during surgery can assist in defining precautionary actions in the perioperative setting. Positioning techniques in the operating room, early recognition of neuropathies, and use of a perioperative tool in the postoperative setting are keys to reduce significant clinical complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171121
[Lr] Last revision date:171121
[St] Status:In-Process

  6 / 3890 MEDLINE  
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[PMID]: 29124342
[Au] Autor:Natsis K; Giannakopoulou A; Piagkou M; Lazaridis N; Tegos T; Colonna MR
[Ad] Address:Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, P.O. Box 300, 54124, Thessaloniki, Greece. natsis@auth.gr.
[Ti] Title:Connections between radial and ulnar nerve at high humeral level in cadavers: incidence, topography, and literature review.
[So] Source:Surg Radiol Anat;, 2017 Nov 09.
[Is] ISSN:1279-8517
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: Although communications between branches and cords of the brachial plexus have been extensively published, there is a scarcity of reports concerning radial and ulnar nerve (RN-UN) communication in the arm. The current study aims to demonstrate the incidence, topography, and length of communicating branches between RN and UN. Any additional coexisted variations were also recorded. MATERIALS AND METHODS: Two hundred and sixty-six upper limbs collected from one hundred and thirty-three (81 males and 52 females) Greek cadavers were dissected. RESULTS: Three out of one hundred and thirty-three cadavers, accounting for an incidence of up to 2.3%, were found to have an atypical communicating branch originating at a high humeral level from RN towards UN. In two cadavers, communicating branches were detected on the left side and in one cadaver bilaterally. CONCLUSIONS: The study of atypical communications between RN and UN attracts great attention for its clinical importance, mainly in cases of peripheral neuropathies with diagnostic dilemma or upper limb nerve injury producing an otherwise unexpected symptomatology due to the aberrant nerve supply. Familiarity with these variations is crucial in avoiding misdiagnosis and preserving valuable communicating branches, thus achieving an uneventful outcome in cases of upper limb nerve injury repair.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171110
[Lr] Last revision date:171110
[St] Status:Publisher
[do] DOI:10.1007/s00276-017-1939-3

  7 / 3890 MEDLINE  
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[PMID]: 28976477
[Au] Autor:Schwarz D; Kele H; Kronlage M; Godel T; Hilgenfeld T; Bendszus M; Bäumer P
[Ad] Address:From the *Department of Neuroradiology, Heidelberg University Hospital, Heidelberg; †Center for Neurology and Clinical Neurophysiology, Hamburg; and ‡Department of Radiology, German Cancer Research Institute, Heidelberg, Germany.
[Ti] Title:Diagnostic Value of Magnetic Resonance Neurography in Cervical Radiculopathy: Plexus Patterns and Peripheral Nerve Lesions.
[So] Source:Invest Radiol;, 2017 Oct 02.
[Is] ISSN:1536-0210
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The aim of this study was to assess the imaging appearance and diagnostic value of plexus and peripheral nerve magnetic resonance neurography (MRN) in cervical radiculopathy. MATERIALS AND METHODS: This prospective study was approved by our institutional ethics committee and written informed consent was obtained from all participants. A total of 24 patients were included with a diagnosis of cervical radiculopathy based on clinical examination, supporting electrophysiological examinations and spinal imaging consistent with the clinical syndrome. All patients then underwent a high-resolution MRN protocol including the brachial plexus from nerve roots to plexus cords using a 3-dimensional turbo spin echo with variable flip angle short tau inversion recovery and sagittal-oblique T2-weighted spectral adiabatic inversion recovery sequence, and ulnar, median, and radial nerves at the upper arm and elbow in T2-weighted fat saturated sequences. Two readers independently rated plexus elements regarding the presence of lesions at neuroforaminal levels, roots, trunks, and cord segments. Median, ulnar, and radial nerves were likewise rated. Findings were then compared to a referenced standard of cervical radiculopathy that was defined as the combined diagnosis of clinical syndrome including supporting electrophysiological exams and matching positive spinal imaging, and diagnostic performance parameters were calculated. Additional quantitative and qualitative analysis assessed peripheral nerve caliber and normalized T2-signal at arm level in cervical radiculopathy and compared them to 25 inflammatory neuropathy controls. RESULTS: Cervical radiculopathy resulted in distinct plexus lesion patterns for each level of neuroforaminal stenosis. Overall, brachial plexus MRN in cervical radiculopathy reached a sensitivity of 81%, a specificity of 96%, a positive predictive value of 87%, and overall diagnostic accuracy of 87%. Initial spinal magnetic resonance imaging showed multiple positive findings for clinically unaffected root levels and resulted in a specificity of 69%, a positive predictive value of 54%, and an overall diagnostic accuracy of 78%.T2-weighted peripheral nerve lesions were detected in 79% of cervical radiculopathy cases and imitated imaging appearance of inflammatory neuropathies both quantitatively and qualitatively. CONCLUSIONS: Complementing spine imaging in cervical radiculopathy with brachial plexus MRN can improve diagnostic accuracy by increasing specificity and positive predictive value. T2-weighted lesions of peripheral nerves can be caused by cervical radiculopathy, which must be considered a relevant diagnostic pitfall in MRN of peripheral neuropathies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171004
[Lr] Last revision date:171004
[St] Status:Publisher
[do] DOI:10.1097/RLI.0000000000000422

  8 / 3890 MEDLINE  
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[PMID]: 28975000
[Au] Autor:Bank AM; Bianchi MT; Mukerji SS
[Ad] Address:Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
[Ti] Title:Winged Scapula Secondary to Neuroborreliosis.
[So] Source:Neurohospitalist;7(4):200-201, 2017 Oct.
[Is] ISSN:1941-8744
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 171008
[Lr] Last revision date:171008
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1177/1941874416673280

  9 / 3890 MEDLINE  
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[PMID]: 28768846
[Au] Autor:van Eijk JJJ; Dalton HR; Ripellino P; Madden RG; Jones C; Fritz M; Gobbi C; Melli G; Pasi E; Herrod J; Lissmann RF; Ashraf HH; Abdelrahim M; Masri OABAL; Fraga M; Benninger D; Kuntzer T; Aubert V; Sahli R; Moradpour D; Blasco-Perrin H; Attarian S; Gérolami R; Colson P; Giordani MT; Hartl J; Pischke S; Lin NX; Mclean BN; Bendall RP; Panning M; Peron JM; Kamar N; Izopet J; Jacobs BC; van Alfen N; van Engelen BGM
[Ad] Address:From the Jeroen Bosch Hospital (J.J.J.v.E.), 's-Hertogenbosch, the Netherlands; Royal Cornwall Hospital (H.R.D., R.G.M., C.J., J. Herrod, R.F.L., H.H.A., M.A., O.A.B.A.L.M., B.N.M., R.P.B.); European Centre for the Environment and Human Health (H.R.D., R.P.B.), University of Exeter, Truro, UK; Neuro
[Ti] Title:Clinical phenotype and outcome of hepatitis E virus-associated neuralgic amyotrophy.
[So] Source:Neurology;89(9):909-917, 2017 Aug 29.
[Is] ISSN:1526-632X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To determine the clinical phenotype and outcome in hepatitis E virus-associated neuralgic amyotrophy (HEV-NA). METHODS: Cases of NA were identified in 11 centers from 7 European countries, with retrospective analysis of demographics, clinical/laboratory findings, and treatment and outcome. Cases of HEV-NA were compared with NA cases without evidence of HEV infection. RESULTS: Fifty-seven cases of HEV-NA and 61 NA cases without HEV were studied. Fifty-six of 57 HEV-NA cases were anti-HEV IgM positive; 53/57 were IgG positive. In 38 cases, HEV RNA was recovered from the serum and in 1 from the CSF (all genotype 3). Fifty-one of 57 HEV-NA cases were anicteric; median alanine aminotransferase 259 IU/L (range 12-2,961 IU/L); in 6 cases, liver function tests were normal. HEV-NA cases were more likely to have bilateral involvement (80.0% vs 8.6%, < 0.001), damage outside the brachial plexus (58.5% vs 10.5%, < 0.01), including phrenic nerve and lumbosacral plexus injury (25.0% vs 3.5%, = 0.01, and 26.4% vs 7.0%, = 0.001), reduced reflexes ( = 0.03), sensory symptoms ( = 0.04) with more extensive damage to the brachial plexus. There was no difference in outcome between the 2 groups at 12 months. CONCLUSIONS: Patients with HEV-NA are usually anicteric and have a distinct clinical phenotype, with predominately bilateral asymmetrical involvement of, and more extensive damage to, the brachial plexus. Involvement outside the brachial plexus is more common in HEV-NA. The relationship between HEV and NA is likely to be causal, but is easily overlooked. Patients presenting with NA should be tested for HEV, irrespective of liver function test results. Prospective treatment/outcome studies of HEV-NA are warranted.
[Mh] MeSH terms primary: Brachial Plexus Neuritis/physiopathology
Hepatitis E virus
Hepatitis E/physiopathology
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Brachial Plexus/diagnostic imaging
Brachial Plexus/physiopathology
Brachial Plexus Neuritis/diagnostic imaging
Brachial Plexus Neuritis/drug therapy
Brachial Plexus Neuritis/pathology
Europe
Female
Hepatitis Antibodies/blood
Hepatitis E/drug therapy
Hepatitis E/pathology
Hepatitis E/virology
Humans
Immunoglobulin G/blood
Immunoglobulin M/blood
Liver Function Tests
Male
Middle Aged
Phenotype
RNA, Viral/blood
RNA, Viral/cerebrospinal fluid
Retrospective Studies
Treatment Outcome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Name of substance:0 (Hepatitis Antibodies); 0 (Immunoglobulin G); 0 (Immunoglobulin M); 0 (RNA, Viral)
[Em] Entry month:1709
[Cu] Class update date: 170901
[Lr] Last revision date:170901
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170804
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004297

  10 / 3890 MEDLINE  
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[PMID]: 28762574
[Au] Autor:Goedee HS; Jongbloed BA; van Asseldonk JH; Hendrikse J; Vrancken AFJE; Franssen H; Nikolakopoulos S; Visser LH; van der Pol WL; van den Berg LH
[Ad] Address:Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
[Ti] Title:A comparative study of brachial plexus sonography and magnetic resonance imaging in chronic inflammatory demyelinating neuropathy and multifocal motor neuropathy.
[So] Source:Eur J Neurol;24(10):1307-1313, 2017 Oct.
[Is] ISSN:1468-1331
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND AND PURPOSE: To compare the performance of neuroimaging techniques, i.e. high-resolution ultrasound (HRUS) and magnetic resonance imaging (MRI), when applied to the brachial plexus, as part of the diagnostic work-up of chronic inflammatory demyelinating neuropathy (CIDP) and multifocal motor neuropathy (MMN). METHODS: Fifty-one incident, treatment-naive patients with CIDP (n = 23) or MMN (n = 28) underwent imaging of the brachial plexus using (i) a standardized MRI protocol to assess enlargement or T2 hyperintensity and (ii) bilateral HRUS to determine the extent of nerve (root) enlargement. RESULTS: We found enlargement of the brachial plexus in 19/51 (37%) and T2 hyperintensity in 29/51 (57%) patients with MRI and enlargement in 37/51 (73%) patients with HRUS. Abnormal results were only found in 6/51 (12%) patients with MRI and 12/51 (24%) patients with HRUS. A combination of the two imaging techniques identified 42/51 (83%) patients. We found no association between age, disease duration or Medical Research Council sum-score and sonographic nerve size, MRI enlargement or presence of T2 hyperintensity. CONCLUSIONS: Brachial plexus sonography could complement MRI in the diagnostic work-up of patients with suspected CIDP and MMN. Our results indicate that combined imaging studies may add value to the current diagnostic consensus criteria for chronic inflammatory neuropathies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170914
[Lr] Last revision date:170914
[St] Status:In-Process
[do] DOI:10.1111/ene.13380


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