Afectación de fibras finas en la patología del nervio periférico

Santiago, S; Espinosa, Marcelo; Pérez-Conde, M.C.; Merino, Matías Ezequiel Díaz; Ferrer, Teresa

doi:10.33588/rn.2806.98456

Cited by 4 publications

(3 citation statements)

References 52 publications

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“…Nuestro estudio encontró un mayor compromiso motor de los nervios de las extremidades superiores: mediano derecho 82% y cubital izquierdo 66%, en relación a las extremidades inferiores: tibial posterior izquierdo 52% y ciático poplíteo externo izquierdo 54%, que contrasta con estudios similares que reportan una mayor afectación de las extremidades inferiores en estos pacientes ( [19][20][21] ). Nuestro estudio sólo evalúo la VCNS en las extremidades inferiores, por lo que no pudo ser comparado con otros estudios que reportan compromiso sensitivo simétrico en las 4 extremidades ( [20][21][22] ).…”

Section: Discussionunclassified

Evaluación neurofisiológica y clínica en pacientes con diabetes mellitus

2013

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Objetivo: Determinar las características clínicas y hallazgos neurofisiológicos en pacientes diabéticos y correlacionar sus variables. Material y Métodos: Se evaluó 50 pacientes con diabetes mellitus del Hospital Nacional Guillermo Almenara. Se determinó edad, sexo, ocupación, tiempo de enfermedad, glicemia, dieta, tratamiento, sintomatología sensitiva, velocidad de conducción nerviosa motora y sensitiva de 12 nervios por paciente, 600 nervios en total, prevalencia de polineuropatía diabética (PND) y relacionamos las variables con la PND. Resultados: El 90% de pacientes presentó compromiso, 86% con criterios de PND; la edad osciló entre 38 y 78 años (media=58,5 años), 36 fueron varones (72%), el tiempo de enfermedad promedio fue de 89 meses, la glicemia 143 mg/dL, 74% tenía dieta hipoglúcida, 48% refirió síntomas sensitivos. No hubo relación de PND con tiempo de enfermedad, glicemia, tratamiento o sintomatología sensitiva. Conclusiones: La exhaustiva anamnesis a pacientes diabéticos encontró 48% de sintomatología sugestiva de PND, 86% presentó hallazgos neurofisiológicos compatibles con PND, que no fue influida por otras variables; es imperativa la detección temprana de diabetes mellitus, para evitar complicaciones como la PND.

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Section: Discussionunclassified

Evaluación neurofisiológica y clínica en pacientes con diabetes mellitus

2013

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“…The most common site of small fiber involvement is at the distal nerve branches at the skin, although non-length-dependent involvement has been described. Here, we provide a growing list of conditions that can lead to selective small fiber involvement in humans, at least during part of the natural course of the condition (Table) 11, 13,14,15,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,333,34,35,36,37,38,39,40,41,42,43,44 .…”

Section: Mechanisms Of Selective Small Fiber Involvementmentioning

confidence: 99%

Definition and diagnosis of small fiber neuropathy: consensus from the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology

Gondim

Barreira

Claudino

et al. 2018

Arq. Neuro-Psiquiatr.

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The aim of this study was to describe the results of a Brazilian Consensus on Small Fiber Neuropathy (SFN). Fifteen neurologists (members of the Brazilian Academy of Neurology) reviewed a preliminary draft. Eleven panelists got together in the city of Fortaleza to discuss and finish the text for the manuscript submission. Small fiber neuropathy can be defined as a subtype of neuropathy characterized by selective involvement of unmyelinated or thinly myelinated sensory fibers. Its clinical picture includes both negative and positive manifestations: sensory (pain/dysesthesias/pruritus) or combined sensory and autonomic complaints, associated with an almost entirely normal neurological examination. Standard electromyography is normal. A growing list of medical conditions is associated with SFN. The classification of SFN may also serve as a useful terminology to uncover minor discrepancies in the normal values from different neurophysiology laboratories. Several techniques may disclose sensory and/or autonomic impairment. Further studies are necessary to refine these techniques and develop specific therapies.

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“…Like mexiletine, carbamazepine blocks voltage-gated sodium channels that are mainly expressed in peripheral C and Aδ nerve fibers [4]. Dysfunction of these small, un-or thinly myelinated fibers is associated with several chronic pain disorders, including small fiber neuropathies and fibromyalgia [19][20][21][22]. In contrast to neuropathic pain, muscle pain is considered to be nociceptive.…”

Section: Introductionmentioning

confidence: 99%

Carbamazepine for Chronic Muscle Pain: A Retrospective Assessment of Indications, Side Effects, and Treatment Response

et al. 2023

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Myopathies fall under the umbrella of rare diseases, however, muscle pain is a relevant, under-recognized symptom with limited treatment options. Carbamazepine is an oral sodium channel blocker approved for the treatment of seizures and neuropathic pain. In 54 individuals receiving carbamazepine for muscle pain, we retrospectively assessed the subjective treatment response, side effects, and reasons for carbamazepine discontinuation. The underlying diagnoses leading to muscle pain were diverse, ranging from metabolic (n = 5) and other hereditary (n = 9) to acquired (n = 2) myopathies and myotonia syndromes (n = 22). Under carbamazepine (daily dose 254 ± 138 mg), patients reported a significant reduction of pain, quantified by an 11-point numeric rating scale (−1.9 ± 1.8, p < 0.001). Compared to age- and sex-matched controls, our sensory assessment revealed a significant dysfunction of Aδ-nerve fibers in patients with chronic muscle pain. Neuropathic pain components identified by the painDETECT questionnaire or quantitative sensory testing did not seem to influence the reported treatment response. Side effects (n = 18) such as fatigue, elevated liver enzymes, and diarrhea, as well as lack of pain improvement (n = 6), led to carbamazepine discontinuation in 44.4% (24/54). Mediated by dysfunctional Aδ-nerve fibers, muscle pain is common in a variety of myopathies. Carbamazepine may reduce pain levels, but comes with therapy-limiting side effects.

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Afectación de fibras finas en la patología del nervio periférico

Cited by 4 publications

References 52 publications

Evaluación neurofisiológica y clínica en pacientes con diabetes mellitus

Evaluación neurofisiológica y clínica en pacientes con diabetes mellitus

Definition and diagnosis of small fiber neuropathy: consensus from the Peripheral Neuropathy Scientific Department of the Brazilian Academy of Neurology

Carbamazepine for Chronic Muscle Pain: A Retrospective Assessment of Indications, Side Effects, and Treatment Response

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