Muscle & nerve
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Fibromyalgia (FM) is a chronic syndrome characterized by widespread pain often accompanied by other symptoms suggestive of neuropathic pain. We evaluated patients for small fiber neuropathy (SFN) who were referred for fibromyalgia (FM). ⋯ A subset of FM subjects have SFN, which may contribute to their sensory and autonomic symptoms. Skin biopsy should be considered in the diagnostic work-up of FM.
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The aim of this ultrasound-anatomical study was to evaluate the ability of high-resolution ultrasound (HRUS) to visualize and infiltrate small subcutaneous nerves of the forearm in anatomic specimens. ⋯ HRUS can identify precisely the small subcutaneous nerves of the forearm and may aid in both diagnosis and therapy in cases of neuropathy.
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Polyneuropathy evaluation in older patients is often challenging due to conflicting data regarding normative values for peripheral nerve testing. ⋯ We propose that an absent sural SNAP in patients up to 75 years of age should be considered abnormal. Our findings also support age- and gender-stratified normative data for IENFD and QSART.
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Our goal in this report was to determine whether symptom progression in primary lateral sclerosis (PLS) was consistent with disease spread through axonal pathways or contiguous cortical regions. The date of symptom onset in each limb and cranial region was obtained from 45 PLS patient charts. ⋯ Symptom progression in PLS patients is consistent with disease spread along axonal tracts and by local cortical spread. Both were equally likely for the first spread event, but local cortical spread was predominant thereafter, suggesting that late degeneration does not advance through long axonal tracts.
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We investigated the clinical, electrophysiological and neural autoantibody characteristics in cramp-fasciculation syndrome (CFS) patients. ⋯ VGKC-complex autoimmunity occurs in a minority of CFS patients. Antibody positivity was associated with extramuscular manifestations, typically without malignancy. Target antigens within the VGKC complex remain unknown in most patients.