Neuropathy peripheral

FEATURES COMMON TO THE PERIPHERAL AND CENTRAL NERVOUS SYSTEM IMPORTANT IN THE PATHOGENESIS AND PATHOPHYSIOLOGY OF NEUROPATHIES 620 

FEATURES OF PERIPHERAL NERVES THAT INFLUENCE THEIR VULNERABILITY TO DISEASE AND CAPACITY FOR REGENERATION 620 

Infections can damage nerves directly, or via exotoxins 621 Antibody- and cell-mediated mechanisms of neuropathy 621 Immune mechanisms contribute to paraneoplastic neuropathies 623 Toxins and hormone deficiency states are frequent causes of neuropathy 623 Many genetically determined neuropathies are now recognized 624 Neurofibromatosis is a frequent cause of peripheral nerve tumors 625 

HEREDITARY AND ACQUIRED DISEASES INVOLVING THE ENTERIC NERVOUS SYSTEM 626 

This chapter provides a short review of peripheral nerve diseases. Diseases that involve motor neurons, the presyn-aptic compartment of neuromuscular junctions, or the enteric nervous system are also discussed. 

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Because of the toxicity of lead, special care must be taken when working with lead ahoys. Lead and its inorganic compounds are neurotoxias which may produce peripheral neuropathy. Eor an overview of the effects of lead exposure, see Occupational Exposure to Lead, Appendix A (29 CRE 1910.1025) (see... 

Attempts to isolate GTF from brewer s yeast have resulted in production of very active concentrates, but the substance is too labile to be obtained in the soHd state (136). However, it has been shown that GTF is a Cr(III) complex containing two coordinated nicotinate radicals and other amino acid anions (146). Active preparations containing similar complexes have been synthesi2ed (147). Chromium deficiency may also lead to atherosclerosis and peripheral neuropathy. 

Therapeutic Function Peripheral neuropathy treatment Chemical Name N-(1-Methylethyl)-2-pyrimidinamine Common Name —... 

Etiology Trauma, viral infections, ischemia, inflammation, genetic defects Neuropathy, genetic defects Peripheral inflammation, peripheral neuropathy, trauma, genetic defects, spinal cord injury, inflammation in the central nervous system ... 

Peripheral neuropathy is degeneration of peripheral nerves. Because motor and sensory axons tun in the same nerves, usually both motor and sensory functions are affected in this disease. Neuropathies may be either acute (e.g., Charcot-Marie-Tooth disease) or chronic (e.g., Guillain-Barre syndrome) and are categorized as demyelinating or axonal. 

The incidence of adverse reactions appears to be higher when larger doses of isoniazid are prescribed. Adverse reactions include hypersensitivity reactions, hematologic changes, jaundice, fever, skin eruptions, nausea, vomiting, and epigastric distress. Severe, and sometimes fatal, hepatitis has been associated witii isoniazid tiierapy and may appear after many months of treatment. Peripheral neuropathy (numbness and tingling of the extremities) is the most common symptom of toxicity. 

Adverse reactions reported with didanosine include headache, peripheral neuropathy, rhinitis, cough, diarrhea, nausea, vomiting, anorexia, hepatotoxicily, and pancreatitis. 

DIDANOSINE Although rare, pancreatitis and peripheral neuropathy are possible adverse reactions seen with didanosine The nurse must be alert for symptoms of pancreatitis (nausea, vomiting, abdominal pain, jaundice, elevated enzymes) and for signs of peripheral neuropathy (numbness, tingling, or pain in the feet or hands). It is important to immediately report these signs to the primary health care provider. 

Convulsive seizures, headache, nausea, and peripheral neuropathy (numbness and tingling of the extremities) have been reported with the use of metronidazole... 

Nitrofurantoin administration may result in nausea, vomiting, anorexia, rash, peripheral neuropathy, headache, brown discoloration of the urine, and hypersensitivity reactions, which may range from mild to severe Acute and chronic pulmonary reactions also have been seen. 

Nausea, skin rash, pruritus, stomatitis, vomiting, anemia, leukopenia, neutropenia, arthralgia, alopeda, asthenia, fever, infections Diarrhea, nausea, vomiting, flushing, myalgia, arthralgia, fever, peripheral neuropathy, opportunistic infections Leukopenia, nausea, vomiting, paresthesias, malaise, weakness, mental depression, headache, hypertension, alopecia, diarrhea, constipation... 

Various syndromes associated with hypereosinophilia involve skeletal muscle. There is a rare form of polymyositis which is characterized by this feature (defined as exceeding 1,500 eosinophils/mm for at least six months). Clinical presentation includes skin changes, heart and lung involvement, and peripheral neuropathy as well as proximal myopathy. The condition must be distinguished from trichinosis and other parasitic infections associated with hypereosinophilia. Muscle biopsy findings are interstitial and perivascular infiltrates in which eosinophils predominate but are accompanied by lymphocytes and plasma cells, and occasional muscle fiber necrosis. Fascitis may also be associated with hypereosinophilia (Shulman s syndrome). This condition is characterized by painful swelling of skin and soft tissues of trunk and extremities and weakness of limb muscles. Biopsy of muscle... 

Disulfiram produces a variety of adverse effects, which commonly include drowsiness, lethargy, and fatigue (Chick 1999). Other more serious adverse effects, such as optic neuritis, peripheral neuropathy, and hepatotoxicity, are rare. Psychiatric effects of disulfiram are also uncommon. They probably occur only at higher dosages of the drug and may result from the inhibition by disulfiram of a variety of enzymes in addition to ALDH. Included among the enzymes inhibited by disulfiram is dopamine P-hydroxylase, inhibition of which increases dopamine levels, which in turn can exacerbate psychotic symptoms in patients with schizophrenia and occasionally may result in psychotic or depressive symptoms in patients without schizophrenia. 

Before an antiviral agent becomes a drug, advanced toxicity testing, pharmacological combination, and drug-interaction studies are needed. The use of new cell-based assays that can predict mitochondrial toxicity, lactic acidosis, peripheral neuropathy, anemia, hypersensitivity, lipodystrophy, and other potential side effects can alleviate these issues (Stuyver et al. 2002). 

At the start of the HIV epidemic in the 1980s, the peripheral nervous system involvement in HIV infection was not widely appreciated. However, as the number of cases grew, it became obvious that not only were peripheral neuropathies common in HIV infection, but were also present in all stages of the disease, from seroconversion through end-stage immunodeficiency. The neuropathic complications occurred as a result of a variety of pathological processes in HIV infection (Verma 2001). 

Prevalence and Risk Factors of HIV-Associated Peripheral Neuropathy... 

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