Immune-mediated motor neuropathies are most often disorders manifest clinically by slowly progressive, asymmetrical, distal weakness, starting in the hands more often than the legs. In some cases, electrophysiological findings show multifocal conduction block along the length of motor axons. Other patients have findings consistent with only axonal loss. Laboratory testing is unremarkable except for high-titre serum autoantibodies to GM1 and other neural antigens. Diagnosis of immune-mediated motor neuropathies provides an opportunity for effective immunomodulating therapy that can significantly improve quality of life in affected patients. The identification of antigenic targets of serum autoantibodies in patients with motor neuropathies lends hope that immunotherapies to specifically treat the autoimmune disorder can be developed.
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Cureus
December 2024
Internal Medicine, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, GBR.
Diabetic lumbosacral radiculoplexus neuropathy, also known as diabetic lumbosacral plexopathy or diabetic amyotrophy, is a rare complication of diabetes mellitus. Due to its varied clinical presentation and wide differential, it may pose a diagnostic quandary in assessing patients with proximal asymmetrical lower limb weakness. We present the case of a 74-year-old female patient with a recent onset of falls and aim to discuss the aetiology, differentials, and treatment modalities in diabetic plexopathy.
View Article and Find Full Text PDFCureus
December 2024
Department of General Medicine, Father Muller Medical College, Bangalore, IND.
Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that imposes significant complications, including diabetic peripheral neuropathy (DPN). DPN is characterized by marked inflammation, and the fibrinogen-to-albumin ratio (FAR) is one of the new markers for systemic inflammation, it has been used in various diabetic micro- and macro-vascular complications. The present study investigates the association between FAR and nerve conduction abnormalities in T2DM patients with DPN.
View Article and Find Full Text PDFJ Hand Ther
December 2024
Faculty of Health Sciences, Western University, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada; School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Background: Distal radius fractures (DRF) and ulnar neuropathy (UNE) present with reduced motor function, restricted range of motion, pain, and reduced grip strength that may lead to similar treatment approaches. With rapid and insidious onset for DRF and UNE, respectively, the contextual factors impacting an individuals' experience with the condition can vary.
Purpose: The aim of this secondary analysis is to compare ratings of quality of life (QoL) domains prior to treatment and 3 months post treatment for DRF and UNE.
Cureus
December 2024
Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.
Myasthenia gravis (MG) is characterized by weakness and rapid fatigue of voluntary muscles. Here, we present two cases of early-onset MG, complicated with M-proteinemia and demyelinating neuropathy. Case one was diagnosed with MG at age 29, received tacrolimus post-thymectomy, and developed M-proteinemia and demyelinating neuropathies at age 66 before being diagnosed with B-cell lymphoma.
View Article and Find Full Text PDFPlast Reconstr Surg
December 2024
The Peripheral Nerve Injury Service, University Hospitals Birmingham NHS Foundation Trust, UK.
Background: Transfer of the supinator motor branches to the posterior interosseous nerve (SPIN) was first described as a reliable method of restoration of digit extension in cases of paralysis when there is retained function in the 5th and 6th cervical nerve roots with loss of function in the 8th cervical nerve root.
Methods: We performed a retrospective review of all the SPIN transfers that were performed in our unit which included 16 limbs in 14 patients over a 6-year period. The median age was 49 years (range 22-74).
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