Polyneuritis, peripheral

Chloramphenicol may cause retinal bleeding (as a symptom of aplastic anaemia), alterations in the perception of colours, and optic neuritis. The latter type of side effect has been observed especially in children with cystic fibrosis receiving chloramphenicol in relatively high doses for fairly long periods (38 ). Deficiency of B vitamins is believed to be the cause of the optic neuritis, and perhaps also of the polyneuritis, peripheral neuritis, and paraesthesiae of the legs sometimes seen after prolonged courses of treatment with chloramphenicol and thiam-phenicoL Administration of extra vitamins may protect patients from this type of reversible side effect (SED VIII, p. 610 38 ). 

A study of 484 tuberculosis patients on isoniazid showed that the development of peripheral neuropathy in a subgroup of patients was due to inherited differences in the acetylation of this medication [4], Individuals could be divided into rapid or slow acetylators of isoniazid. Family studies showed that rapid or slow acetylation status was inherited, with rapid acetylation being dominant and slow acetylation recessive. Polyneuritis was found to occur in 4 out of 5 slow acetylators, while only 2 out of 10 rapid acetylators developed polyneuritis. The rapid acetylators also tolerated longer courses of the drug [4],... 

Polyneuritis is a disorder of the peripheral nerves. It involves damage to the myelin sheath. The condition is due to inflammation of the axonal membrane caused by viral or bacterial attack, i.e. an antoimmnne disease. Guillain-Barre syndrome is one form of polynenritis and is an example of an autoimmune disease caused by immune mimicry in response to a bacterial or viral antigen. It is discnssed in Chapter 17. 

Adverse reactions may include acneiform eruptions allergic dermatitis arthropathy multiple cases of cholestatic and fulminant hepatitis drowsiness fatigue headache hepatotoxicity resembling viral or alcoholic hepatitis impotence metallic or garlic-like aftertaste peripheral neuropathy polyneuritis optic or retrobulbar neuritis restlessness occasional skin eruptions. 

Beriberi (characterized by nerve involvement - peripheral neuritis), Wernicke s encephalopathy (characterized by ophthalmoplegia, polyneuritis and mental disorientation). 

In cattle, a thiamine deficiency causes podioencephalomalcia (PEM), characterized by blindness, decreased feed intake, incoordination, failure of rumen to contract, spasms, and paralysis. In swine, a deficiency retards growth and sometimes causes cyanosis (insufficient oxygen in blood), enlarged heart, accompanied by fatly degeneration of heart muscles. Chicks suffer from paralysis of peripheral nerves, causing polyneuritis (head drawn back). 

Thiamin is important as a component of the coenzyme thiamin pyrophosphate (TPP) (cocarboxylase). Good sources are lucerne, grains and yeast. A deficiency is less frequently encountered than deficiencies of other vitamins, since thiamin occurs in abundance in whole grains which make up the major part of poultry diets. A diet deficient in thiamin results in nervous disorders in both young and old birds, and eventual paralysis of the peripheral nerves (polyneuritis). 

Most of the current toxicological information suggests that heptane is, physiologically speaking, more neurotoxic than other aliphatic hydrocarbons such as pentane, hexane, and octane. However, debilitating peripheral neuropathy, such as that seen on chronic exposure to -hexane, has not been observed in animals or humans. Some cases of polyneuritis, observed in the absence of hexane exposure, might be attributed to the presence of heptane in a solvent mixture. No one to date has discerned a true toxic mechanism for heptane. 

Harris S. Jamaica ginger paralysis (a peripheral polyneuritis). South Med J 1930 23 375-380. 

Although thalidomide showed no toxicity to laboratory animals when tested by Ciba and Chemie Grunenthal A.G., potentially irreversible peripheral polyneuritis was soon identified in patients following long-term use of thalidomide. Symptoms... 

Human yr (F) 0.027 0.058 (tendon hyperflexia, peripheral anesthesia, pain in extremities, polyneuritis) Yang et al. 1983 organic... 

Peripheral neuropathy, polyneuritis, ataxia, incoordination, slurred speech, opsoclonus, tremors, twitching, jerking, seizures, electroencephalogram changes, visual changes... 

Neurological Headache, ataxia, fasciculations, seizures, tremor, coma, weakness, electroencephalogram abnormalities, peripheral neuropathy, tinnitus, vertigo, polyneuritis, retrobulbar neuritis, spinal cord involvement, death... 

HEALTH SYMPTOMS inhalation (nausea, vomiting, diarrhea, polyneuritis, degeneration of peripheral motor nerves, paralysis of extremities). 

Another disease resulting from a deficiency is beriberi, which has been known in China for more than 1,000 years. It occurs above aU in southern and eastern Asia, but also in Alaska, Brazil, South Africa, the Congo and Senegal. The ailment is caused by a slow degeneration ofthe peripheral nerves (manifesting as polyneuritis in birds). The first symptom is the beginning of impaired sensory perception in the skin of the lower limbs, followed by muscle weakness, especially in the legs, but in severe cases also in hips and hands, and finally dropsy and heart weakness. Untreated, the illness leads to death. On account of... 

RCT, randomized controiied triai with positive resuits MA, metaanalysis of RCTs with positive resuits OA, osteoarthritis CLBP, chronic low back pain FMS, fibromyaigia syndrome Diabetic PN = diabetic peripheral neuropathy PHN, post-herpetic neuraigia Painfui polyneur, painful polyneuropathy n.t, not tested Neg., negative results in 2 1 RCT Contra, contradictory evidence. 

In 1897 Eijkman, a Dutch doctor in Java, noticed that domestic fowls fed on scraps from the food of prisoners which consisted mainly of polished rice developed symptoms of polyneuritis. This condition in which there is inflammation of the peripheral nerves was very similar to beriberi, a disease from which some of the prisoners suffered. When whole grain instead of polished rice was given the birds recovered. Eijkman then showed that a substance was present in very small amounts in the husk and germ of the rice that protected the birds. These and other findings led to the discovery of vitamin Bi ... 

Under the microscope perineurium and endoneurium are thickened. Typically (Dereux 1963) but not always (Veltema and Verjaal 1961) the appearance resembles that of hypertrophic polyneuritis, type Dejerine-Sottas (Edstrom et al. 1959). Microscopic lesions vary in intensity in different sections, and are most marked where the tissue appears edematous on gross examination. Here, the axis cylinders are diminished in number and are separated by an amorphous material which stains metachromatic with cresyl violet, toluidin blue and PAS (Cammermeyer 1956). The accumulation of serous fluid which apparently is responsible for the swelling (Gordon and Hudson 1959, Alexander 1966) may be limited to peripheral bundles, and the metachromatic material may become less or may... 

Peripheral neuropathy, due to involvement of the vasa vasorum, is noted in 30% to 43% of patients during the course of the disease (3,5,79-81,91). Most common manifestations include mononeuritis multiplex or polyneuritis (3,5,79). Peripheral neuropathy is more common in males, older age, greater extent of disease, and higher titers of ANCA (79). In some patients, biopsy of the sural nerve or other affected nerves may substantiate the diagnosis. Both peripheral and CNS manifestations may be associated with irreversible damage, persisting even after the acute inflammation is adequately controlled. 

Negligible >40 Increased malaise, loss of body weight, intermittent claudication and polyneuritis, bradycardia, peripheral oedema, cardiac enlargement, ophthalmoplegia... 

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