Sural nerve

The neuropathological analysis of HIV-associated neuropathies should include the different central and peripheral nervous system structures associated with sensory pathways, including spinal cord, dorsal root ganglia (DRG), peripheral nerve, and cutaneous nerve fibers (Pardo et al. 2001) (Fig. 4.1). The majority of studies have focused on the evaluation of the peripheral nerve, often from sural nerve biopsies and the DRG. Few studies have examined the pathology of sensory pathways in the... 

A number of cases of subacute sensory motor polyneuropathy have been described among sterilizing workers exposed to ethylene oxide. Findings have included weakness with bilateral foot drop, sensory loss, loss of reflexes, and neuropathologic changes on EMG in the lower extremities. In some cases, sural nerve biopsy showed axonal degeneration. Removal from exposure resulted in resolution of symptoms in 1-7 months. The abnormalities have... 

In the subchronic neurotoxicity study, end points measured are similar to those measured in the acute neurotoxicity study. However, the duration of dosing is 90 days and exposure to the test material is usually via the diet. As for the acute neurotoxicity study, these studies consist of three test groups and a control group. The functional observation battery and motor activity tests are conducted at selected intervals such as weeks 5, 9, and 13, as well as pretest. At test termination, at least 6 animals per group are perfused via the heart with fixative to ensure optimal fixation of nervous tissues for histopathology examination. Nervous tissues examined include brain, spinal cord (various segments), and selected nerves such as the optic, sciatic, tibial, and sural nerves. 

Among the pathologies associated with RLS, several groups [38, 40] have reported neuropathies and radiculopathies. Evidence of peripheral axonal neuropathy of a mild degree was found in some putative idiopathic RLS patients through electro-physiological (EMG/NCV) and psychophysiological tests, subsequently confirmed by sural nerve biopsy [41], These data have recently been confirmed in 30 % of 22 patients by means of skin biopsy, and related to late onset associated with pain-like symptoms [42],... 

Nerve conduction velocities were measured in 55 employees of a 2,4,5-T and 2,4-D manufacturing facility in Jacksonville, Arkansas (Singer et al. 1982). Statistically significant decreases in median motor nerve and sural nerve conduction velocities were observed, as compared to a control group of workers not exposed to phenoxy herbicides. No effect on median sensory nerve conduction velocity was found. Sural nerve conduction velocity was significantly inversely correlated with duration of employment. 

Bosboom WMJ, Van den Berg LH, Mollee I, Sasker LD, Jansen J, Wokke JHJ, Logtenberg T (2001b) Sural nerve T-cell receptor V beta gene utilization in chronic inflammatory demyelin-ating polyneuropathy and vasculitic neuropathy. Neurology 56 74-81. 

Eiihaiiced B7 cosdmulatory molecule expression in inflammatory human sural nerve biopsies. J Neurol Neurosurg Psycliia-tr-y 69 362-368. 

Lindenlaub R, Sommer C (2003) Cytokines in sural nerve biopsies from inflammatory and non-inflanimatory neuropadiies. Acta Neuropadiol (Beri) 105 593-602. 

Bosboom WM, Van den Berg LH. Franssen H. Giesbergen PC, Flach HZ, van Putten AM, Veldman H, Wokke JH (2001a) Diagnostic value of sural nerve demyelination in chronic inflammatory demy-elinating polyneuropathy. Brain 124 2427-2438. 

Krendel DA, Parks HP, Anthony DC, St Clair MB, Graham DG (1989) Sural nerve biopsy in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve 12 257-264. 

Schmidt B, Toyka KV, Kiefer R, Full J, Hartung HP, Pollard J (1996) Inflammatory infiltrates in sural nerve biopsies in Gnillain-Barre syndrome and chronic inflammatory demyelinating nenropathy. Mnscle Nerve 19 474-487. 

Sommer C, Koch S, Lammens M, Gabreels-Festen A, Stoll G, Toyka KV (2005) Macrophage clustering as a diagnostic marker in sural nerve biopsies of patients with CIDP. Neurology 65 1924—1929. 

Cornblath DR, Griffin DE, Welch D, Griffin JW, McArthur JC (1990) Quantitative analysis of endoneurial T-ceUs in human sural nerve biopsies. J Neuroimmunol 26 113-118. 

Hughes R, Atkinson P, Coates P, Hall S, Leibowitz S (1992) Sural nerve biopsies in Guillain-Barre syndrome Axonal degeneration and macrophage-associated demyelination and absence of cytomegalovirus genome. Muscle Nerve 15 568-575. 

Schroder JM, Hoheneck M, Weis J, Deist H. Ethylene oxide polyneuropathy clinical follow-up study with morphometric and electron microscopic findings in a sural nerve biopsy. J Neurol 1985 232(2) 83-90. 

A 36-year-old man developed peripheral polyneuropathy after chronic perianal use of an ammoniated mercury ointment. He had very high blood and urine mercury concentrations. Sural nerve biopsy showed mixed axonal degeneration/demyelination. His symptoms improved progressively over 2 years after withdrawal of the ointment, but neurophysiological recovery was incomplete. 

Sensory neuropathy was reported as an adverse effect in eight patients with homocystinuria who took 600-1200 mg/day of pyridoxine for 4-22 years. Nerve conduction studies of the sural nerve in five affected patients showed abnormalities in four (21). Neuropathies have been observed in women taking doses as low as 50-500 mg/day for one to several months (22,23). 

A 67-year-old woman with lymphoma presented with a neuromyopathy following treatment with laetrile. She had high blood and urinary thiocyanate and cyanide concentrations (7). Sural nerve biopsy specimen showed a mixed pattern of demyelination and axonal degeneration, the latter being prominent. Gastrocnemius muscle biopsy specimen showed a mixed pattern of denervation and myopathy with type II atrophy. 

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