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Painful diabetic polyneuropathy

Magdalena Lang, Roi Treister, Anne Louise Oaklander
Small-fiber polyneuropathy (SFPN) causes non-specific symptoms including chronic pain, cardiovascular, gastrointestinal, and sweating complaints. Diagnosis is made from history and exam in patients with known risk factors such as diabetes, but objective test confirmation is recommended for patients without known risks. If tests confirm SFPN, and it is "initially idiopathic" (iiSFPN), screening for occult causes is indicated. This study's aim was to evaluate the 21 widely available, recommended blood tests to identify the most cost-effective ones and to learn about occult causes of iiSFPN...
October 11, 2016: Journal of Neurology
R Hanewinckel, M A Ikram, P A Van Doorn
Peripheral neuropathies are diseases of the peripheral nervous system that can be divided into mononeuropathies, multifocal neuropathies, and polyneuropathies. Symptoms usually include numbness and paresthesia. These symptoms are often accompanied by weakness and can be painful. Polyneuropathies can be divided into axonal and demyelinating forms, which is important for diagnostic reasons. Most peripheral neuropathies develop over months or years, but some are rapidly progressive. Some patients only suffer from mild, unilateral, slowly progressive tingling in the fingers due to median nerve compression in the wrist (carpal tunnel syndrome), while other patients can be tetraplegic, with respiratory insufficiency within 1-2 days due to Guillain-Barré syndrome...
2016: Handbook of Clinical Neurology
Sheng-Shu Chiang, Chia-Lin Lee, Hsiu-Chen Liu, Jun-Sing Wang, I-Te Lee, Yuh-Min Song, Chia-Po Fu, Yu-Fen Li, Wayne H-H Sheu, Shih-Yi Lin
BACKGROUND: Diabetic neuropathy is a common complication in patients with type 2 diabetes. However, the prevalence of painful diabetic polyneuropathy (PDPN) have been less studied. We examined the prevalence and risk factors of PDPN in outpatients with type 2 diabetes in an ethnic Chinese population. METHODS: This retrospective study enrolled 2358 outpatients with type 2 diabetes who had completed the Douleur Neuropathique en 4 Questions (DN4) questionnaire from January 2013 to October 2013...
November 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Corinne G Jolivalt, Katie E Frizzi, Lucie Guernsey, Alex Marquez, Joseline Ochoa, Maria Rodriguez, Nigel A Calcutt
Peripheral neuropathy is a frequent complication of chronic diabetes that most commonly presents as a distal degenerative polyneuropathy with sensory loss. Around 20% to 30% of such patients may also experience neuropathic pain. The underlying pathogenic mechanisms are uncertain, and therapeutic options are limited. Rodent models of diabetes have been used for more than 40 years to study neuropathy and evaluate potential therapies. For much of this period, streptozotocin-diabetic rats were the model of choice...
2016: Current Protocols in Mouse Biology
Patricia M Kluding, J Robinson Singleton, Mamatha Pasnoor, Mazen M Dimachkie, Richard J Barohn, A Gordon Smith, Robin L Marcus
BACKGROUND: Half of all patients with diabetes develop diabetic peripheral neuropathy (DPN), a complication leading to reduced mobility and quality of life. While there are no proven pharmacologic approaches to reduce DPN risk or slow its progression, evidence suggests physical activity may improve symptoms and enhance peripheral nerve regeneration. OBJECTIVE: To determine the impact of an intense lifestyle intervention on neuropathy progression and quality of life in individuals with DPN...
July 14, 2016: Physical Therapy
Reo Inoue, Masahiko Sumitani, Tetsuyuki Yasuda, Mayumi Tsuji, Masaya Nakamura, Iichiro Shimomura, Masahiko Shibata, Yoshitsugu Yamada
Patients with diabetes occasionally develop diabetic polyneuropathy (DPN), which is characterized by both positive symptoms such as pain and negative symptoms such as numbness/dysesthesia. However, these symptoms have always been collectively analyzed to determine their risk factors. This study aimed to independently analyze the risk factors for neuropathic pain and numbness/dysesthesia in DPN patients. In total, 298 patients with diabetes (age: 61.1 ± 10.4 years; 176 male) were included. The relationships among the incidence of DPN and its clinical parameters were determined using logistic regression models...
September 2016: Journal of Pain & Palliative Care Pharmacotherapy
Cinzia D'Amato, Roberto Morganti, Carla Greco, Federica Di Gennaro, Laura Cacciotti, Susanna Longo, Giorgia Mataluni, Davide Lauro, Girolama A Marfia, Vincenza Spallone
AIMS: To investigate the independent effect on depression of painless diabetic polyneuropathy, painful diabetic polyneuropathy, and general and diabetes-related comorbidities. METHODS: In 181 patients, the presence of painless diabetic polyneuropathy, painful diabetic polyneuropathy, comorbidities and depression was assessed using the Michigan Neuropathy Screening Instrument Questionnaire, the Michigan Diabetic Neuropathy Score, nerve conduction studies, the Douleur Neuropathique en 4 Questions, the Charlson Comorbidity Index and the Beck Depression Inventory-II...
June 22, 2016: Diabetes & Vascular Disease Research
Joachim Scholz, James P Rathmell, William S David, David A Chad, Alithia C Broderick, Stephen G Perros, Naomi S Shin, Jenna L Wells, John B Davis, Charles J DiMaggio, Shuang Wang, Simon N Tate
Diabetic polyneuropathy (DPN) is a major cause of neuropathic pain and a frequent target condition in analgesic treatment trials. Differences in the clinical symptoms and signs associated with DPN suggest distinct pathophysiological mechanisms underlying nerve damage and dysfunction that are likely to have therapeutic relevance. The aim of this study was to develop a tool for the bedside assessment of painful neuropathies such as DPN that captures the diversity of phenotypes. Sixty-one patients with type 2 diabetes and painful neuropathy, 19 patients with painless DPN, 25 patients with type 2 diabetes but no clinical evidence of neuropathy, and 20 healthy control subjects completed a structured interview (47 items) and a standardized physical examination (39 items)...
October 2016: Pain
Celal Salcini, Belkis Atasever-Arslan, Gulin Sunter, Hazal Gur, Fatma Busra Isik, Cemil Can Saylan, Ayse Destina Yalcin
Diabetic polyneuropathy is the most common neurologic complication of diabetes mellitus. Underlying mechanisms of diabetic polyneuropathy are related to various metabolic and inflammatory pathways. Pentraxin 3 (PTX3) is an acute phase protein that is produced locally at the inflammatory sites by several cell types. Thioredoxin binding protein 2 (TBP2) is a thioredoxin regulator involved in intracellular energy pathways and cell growth. We measured the plasma levels of PTX3 and TBP2 in type 2 diabetic patients (n = 27) with pain complaints and compared their levels with those of healthy age- and sex-matched subjects (n = 24)...
2016: Tohoku Journal of Experimental Medicine
Richard Bostelmann, Samis Zella, Hans Jakob Steiger, Athanasios K Petridis
Causality between spinal cord compression and polyneuropathy is difficult to define, especially under the circumstances that polyneuropathy can have many causes. Seven patients with spinal cord compression and electrophysiological signs of polyneuropathy were treated surgically on decompression of their spinal canal stenosis in the time from April 2010 to January 2013. Median follow up time was 9 months (2-23 months). Causes of polyneuropathy were: 1 patient with methotrexate-induced polyneuropathy, 1 endocrine-dysfunction-induced, 2 with diabetic-polyneuropathy, and 3 patients had unknown reasons...
March 25, 2016: Clinics and Practice
Agustin Garcia-Caballero, Vinicius M Gadotti, Lina Chen, Gerald W Zamponi
BACKGROUND: Cav3.2 T-type calcium currents in primary afferents are enhanced in various painful pathological conditions, whereas inhibiting Cav3.2 activity or expression offers a strategy for combating the development of pain hypersensitivity. We have shown that Cav3.2 channel surface density is strongly regulated by the ubiquitination machinery and we identified the deubiquitinase USP5 as a Cav3.2 channel interacting protein and regulator of its cell surface expression. We also reported that USP5 is upregulated in chronic pain conditions...
2016: Molecular Pain
Jürgen Eiche, Florian Schache
Pains belong to the most frequent reasons for a doctor's visit. In elderly people, it is the result of progressive degenerative processes (e. g. , arthrosis, Osteoarthritis, degenerative spinal changes) and a higher prevalence of cancer disease to a further increase of the patients who suffer unnecessarily from pains. By the increasing polymorbidity (e.g. diabetes mellitus, vascular disease) and a declining immune competence, the prevalence of polyneuropathy and post-herpetic neuralgia rises. Insufficiently treated chronic or periodically returning pain can lead to serious interferences of the physical, cognitive and social everyday competence and therefore to a limited quality of life...
April 2016: Deutsche Medizinische Wochenschrift
Chieko Suzuki, Tomoya Kon, Yukihisa Funamizu, Tatsuya Ueno, Rie Haga, Haruo Nishijima, Akira Arai, Masahiko Tomiyama, Masayuki Baba
INTRODUCTION: The loss of epidermal nerve fibers is regarded as an early pathological change in human diabetes. We investigated epidermal Aδ nerve fiber function by examining pain threshold by means of intraepidermal electrical stimulation (IES) in early diabetic neuropathy. METHODS: We recruited 20 asymptomatic diabetic patients. Eighteen age-matched, healthy subjects served as controls. We placed the IES electrode onto the skin of the foot dorsum and delivered weak electrical stimulation...
June 2016: Muscle & Nerve
Georgia Gris, Enrique Portillo-Salido, Bertrand Aubel, Yassine Darbaky, Kristof Deseure, José Miguel Vela, Manuel Merlos, Daniel Zamanillo
E-52862 is a selective σ1R antagonist currently undergoing phase II clinical trials for neuropathic pain and represents a potential first-in-class analgesic. Here, we investigated the effect of single and repeated administration of E-52862 on different pain-related behaviours in several neuropathic pain models in rats: mechanical allodynia in cephalic (trigeminal) neuropathic pain following chronic constriction injury of the infraorbital nerve (IoN), mechanical hyperalgesia in streptozotocin (STZ)-induced diabetic polyneuropathy, and cold allodynia in oxaliplatin (OX)-induced polyneuropathy...
2016: Scientific Reports
N P Denisova, D Yu Rogov, D A Rzaev, E A Khabarova, A B Dmitriev
AIM: The study objective was to estimate the efficacy of chronic epidural spinal cord stimulation in the treatment of patients with neuropathic pain syndrome. MATERIAL AND METHODS: A system for chronic spinal cord stimulation (St. Jude) was implanted to 75 patients with neuropathic pain syndrome. Fifty three (70.7%) patients were diagnosed with failed back surgery syndrome (FBSS); 9 (12.0%) patients had complex regional pain syndrome type II; 4 (5.3%) patients had diabetic polyneuropathy of the lower limbs; 3 (4...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Vesna Grbovic, Aleksandra Jurisic-Skevin, Svetlana Djukic, Srdjan Stefanović, Jasmin Nurkovic
[Purpose] Painful diabetic polyneuropathy occurs as a complication in 16% of all patients with diabetes mellitus. [Subjects and Methods] A clinical, prospective open-label randomized intervention study was conducted of 60 adult patients, with distal sensorimotor diabetic neuropathy two groups of 30 patients, with diabetes mellitus type 2 with distal sensorimotor diabetic neuropathy. Patients in group A were treated with combined physical procedures, and patients in group B were treated with alpha lipoic acid...
January 2016: Journal of Physical Therapy Science
Monika Lechleitner, Heidemarie Abrahamian, Claudia Francesconi, Markus Kofler
These are the guidelines for diagnosis and treatment of diabetic neuropathy. This diabetic late complication comprises a number of mono- and polyneuropathies, plexopathies, radiculopathies and autonomic neuropathy. The position statement summarizes characteristic clinical symptoms and techniques for diagnostic assessment of diabetic neuropathy. Recommendations for the therapeutic management of diabetic neuropathy, especially for the control of pain in sensorimotor neuropathy, are provided.
April 2016: Wiener Klinische Wochenschrift
Oscar A de León-Casasola, Victor Mayoral
Topical 5% lidocaine medicated plasters represent a well-established first-line option for the treatment of peripheral localized neuropathic pain (LNP). This review provides an updated overview of the clinical evidence (randomized, controlled, and open-label clinical studies, real-life daily clinical practice, and case series). The 5% lidocaine medicated plaster effectively provides pain relief in postherpetic neuralgia, and data from a large open-label controlled study indicate that the 5% lidocaine medicated plaster is as effective as systemic pregabalin in postherpetic neuralgia and painful diabetic polyneuropathy but with an improved tolerability profile...
2016: Journal of Pain Research
Sophie Fromhold-Treu, Georg Lamprecht
This review describes the gasterointestinal entities, their pathophysiology, clinical presentation, diagnostic workup and therapy that typically involve weight loss as the major presenting symptom. The differentiation of malassimilation into maldigestion and malabsorption is clinically mostly not helpful. Instead primary malasssimilation can be distinguished from secondary due to another disease. Celiac disease, lambliasis, small bowel CD, CVIDS and Whipple's disease result in loss of absorptive surface. Chronic intestinal pseudobstruction leads to weight loss through dysmotility and postprandial pain...
February 2016: Deutsche Medizinische Wochenschrift
Rens Hanewinckel, Marieke van Oijen, M Arfan Ikram, Pieter A van Doorn
Polyneuropathy is a disabling condition of the peripheral nerves, characterized by symmetrical distal numbness and paresthesia, often accompanied with pain and weakness. Although the disease is often encountered in neurological clinics and is well known by physicians, incidence and prevalence rates are not well known. We searched EMBASE, Medline, Web-of-science, Cochrane, PubMed Publisher, and Google Scholar, for population-based studies investigating the prevalence of polyneuropathy and its risk factors. Out of 5119 papers, we identified 29 eligible studies, consisting of 11 door-to-door survey studies, 7 case-control studies and 11 cohort/database studies...
January 2016: European Journal of Epidemiology
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